| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $15.37 | $15.37 | $17.64 | |
Cigna
| Facility | $25.64 | $25.64 | $25.64 | |
Cigna
| Professional | $18.72 | $18.72 | $25.64 | |
United
| Professional | $14.14 | $18.64 | $26.11 |
Orthopedic Shoe Addition Sole Half (Special Coverage Instructions Apply. See Mcm: 2323)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $15.37 | $15.37 | $17.64 | |
Cigna
| Facility | $25.64 | $25.64 | $25.64 | |
Cigna
| Professional | $18.72 | $18.72 | $25.64 | |
United
| Professional | $14.14 | $18.64 | $26.11 |