| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $45.60 | $45.60 | $45.60 | |
Aetna
| Professional | $45.60 | $45.60 | $45.60 | |
Medica
| Facility | $65.20 | $77.06 | $124.94 |
Cervical-thoracic-lumbar-sacral orthosis (CTLSO), immobilizer, infant size, prefabricated, includes fitting and adjustment
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $45.60 | $45.60 | $45.60 | |
Aetna
| Professional | $45.60 | $45.60 | $45.60 | |
Medica
| Facility | $65.20 | $77.06 | $124.94 |