| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $73.33 | $73.33 | $73.33 | |
Cigna
| Facility | $30.72 | $30.72 | $30.72 | |
Cigna
| Professional | $26.11 | $30.72 | $869.25 | |
Molina
| Professional | $45.00 | $45.00 | $60.00 |
Wheelchair Accessory Wheelchair Seat Or Back Cushion Does Not Meet Specific Code Criteria Or No Written Coding Verification From Sadmerc
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $73.33 | $73.33 | $73.33 | |
Cigna
| Facility | $30.72 | $30.72 | $30.72 | |
Cigna
| Professional | $26.11 | $30.72 | $869.25 | |
Molina
| Professional | $45.00 | $45.00 | $60.00 |