| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $20.00 | $20.00 | $20.00 | |
Aetna
| Professional | $20.00 | $25.19 | $364.00 | |
Cigna
| Professional | $27.65 | $117.89 | $117.89 | |
Molina
| Professional | $9.88 | $17.13 | $60.00 |
Repair Of Orthotic Device Repair Or Replace Minor Parts (Special Coverage Instructions Apply. See Mcm: 2133 2100.4 2130d)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $20.00 | $20.00 | $20.00 | |
Aetna
| Professional | $20.00 | $25.19 | $364.00 | |
Cigna
| Professional | $27.65 | $117.89 | $117.89 | |
Molina
| Professional | $9.88 | $17.13 | $60.00 |