| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $34.64 | $34.64 | $34.64 | |
Cigna
| Professional | $0.12 | $0.12 | $0.12 |
Orthopedic Shoe Modification Addition Or Transfer Not Otherwise Specified (Special Coverage Instructions Apply. See Mcm: 2323)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $34.64 | $34.64 | $34.64 | |
Cigna
| Professional | $0.12 | $0.12 | $0.12 |