| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $21.56 | $29.03 | $33.49 | |
Cigna
| Facility | $30.29 | $30.29 | $30.29 | |
Cigna
| Professional | $22.11 | $30.29 | $30.29 | |
United
| Professional | $19.47 | $27.35 | $39.36 |
Orthopedic Shoe Oxford With Supinator Or Pronator Child (Special Coverage Instructions Apply. See Mcm: 2323)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $21.56 | $29.03 | $33.49 | |
Cigna
| Facility | $30.29 | $30.29 | $30.29 | |
Cigna
| Professional | $22.11 | $30.29 | $30.29 | |
United
| Professional | $19.47 | $27.35 | $39.36 |