| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $18.66 | $25.30 | $29.18 | |
Cigna
| Facility | $54.94 | $54.94 | $54.94 | |
Cigna
| Professional | $40.11 | $54.94 | $54.94 | |
United
| Professional | $16.85 | $23.89 | $34.07 |
Foot Molded Shoe Plastazote (Or Similar) Custom Fitted Each (Special Coverage Instructions Apply. See Mcm: 2323)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $18.66 | $25.30 | $29.18 | |
Cigna
| Facility | $54.94 | $54.94 | $54.94 | |
Cigna
| Professional | $40.11 | $54.94 | $54.94 | |
United
| Professional | $16.85 | $23.89 | $34.07 |