| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $798.75 | $798.75 | $998.44 | |
Medica
| Facility | $90.00 | $90.00 | $1,091.64 |
Ko Double Upright Pre Ots
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $798.75 | $798.75 | $998.44 | |
Medica
| Facility | $90.00 | $90.00 | $1,091.64 |