| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $64.00 | $64.00 | $64.00 | |
Cigna
| Professional | $2,559.00 | $2,559.00 | $2,559.00 | |
Medcost
| Facility | $12.25 | $12.25 | $13.11 | |
Molina
| Professional | $30.00 | $30.00 | $30.00 |
Lower Extremi Prosthes, Not Otherwise Specified
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $64.00 | $64.00 | $64.00 | |
Cigna
| Professional | $2,559.00 | $2,559.00 | $2,559.00 | |
Medcost
| Facility | $12.25 | $12.25 | $13.11 | |
Molina
| Professional | $30.00 | $30.00 | $30.00 |