| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $1,663.50 | $3,424.84 | $3,424.84 | |
United
| Professional | $1,219.90 | $1,441.70 | $4,425.89 |
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 |
|---|---|---|---|---|---|
Aetna
| Professional | $1,663.50 | $3,424.84 | $3,424.84 | |
United
| Professional | $1,219.90 | $1,441.70 | $4,425.89 |