| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Providence
| Facility | $266.16 | $266.16 | $4,478.92 | |
United
| Professional | $1,330.80 | $1,330.80 | $2,655.54 |
Power wheelchair, group 2 standard, seat elevator, captain's chair, patient weight capacity up to and including 300 pounds
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Providence
| Facility | $266.16 | $266.16 | $4,478.92 | |
United
| Professional | $1,330.80 | $1,330.80 | $2,655.54 |