| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $5,133.39 | $5,133.39 | $6,850.00 | |
Medica
| Facility | $11,576.50 | $11,576.50 | $18,769.00 |
Power wheelchair, group 4 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $5,133.39 | $5,133.39 | $6,850.00 | |
Medica
| Facility | $11,576.50 | $11,576.50 | $18,769.00 |