| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $13,531.66 | $13,531.66 | $16,247.00 | |
Cigna
| Facility | $11,619.91 | $11,619.91 | $11,619.91 | |
Medica
| Facility | $27,457.43 | $27,457.43 | $44,516.78 |
Power wheelchair, group 5 pediatric, multiple power option, sling/solid seat/back, patient weight capacity up to and including 125 pounds
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $13,531.66 | $13,531.66 | $16,247.00 | |
Cigna
| Facility | $11,619.91 | $11,619.91 | $11,619.91 | |
Medica
| Facility | $27,457.43 | $27,457.43 | $44,516.78 |