| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $14.05 | $28.61 | $101.40 | |
Cigna
| Facility | $10.75 | $10.75 | $10.75 | |
Cigna
| Professional | $7.85 | $10.75 | $10.75 |
Nonstandard size or width
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $14.05 | $28.61 | $101.40 | |
Cigna
| Facility | $10.75 | $10.75 | $10.75 | |
Cigna
| Professional | $7.85 | $10.75 | $10.75 |