| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $5.25 | $5.25 | $5.25 | |
Medica
| Facility | $105.00 | $112.62 | $112.62 |
Upper limb orthosis, not otherwise specified
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $5.25 | $5.25 | $5.25 | |
Medica
| Facility | $105.00 | $112.62 | $112.62 |