| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $60.83 | $65.95 | $68.94 | |
Cigna
| Facility | $98.15 | $98.15 | $98.15 | |
Cigna
| Professional | $71.65 | $71.65 | $98.15 | |
United
| Professional | $66.06 | $74.06 | $101.65 |
Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, unilateral, any size, any type
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $60.83 | $65.95 | $68.94 | |
Cigna
| Facility | $98.15 | $98.15 | $98.15 | |
Cigna
| Professional | $71.65 | $71.65 | $98.15 | |
United
| Professional | $66.06 | $74.06 | $101.65 |