| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $72.62 | $72.62 | $92.00 | |
Cigna
| Facility | $121.82 | $121.82 | $121.82 | |
Cigna
| Professional | $88.93 | $88.93 | $121.82 | |
United
| Professional | $79.48 | $88.03 | $146.71 |
Cervical, semi-rigid, wire frame occipital/mandibular support, prefabricated, off-the-shelf
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $72.62 | $72.62 | $92.00 | |
Cigna
| Facility | $121.82 | $121.82 | $121.82 | |
Cigna
| Professional | $88.93 | $88.93 | $121.82 | |
United
| Professional | $79.48 | $88.03 | $146.71 |