| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $58.33 | $61.22 | $73.34 | |
Medica
| Facility | $100.00 | $146.91 | $146.91 | |
Medica
| Professional | $51.46 | $194.36 | $194.36 | |
United
| Facility | $30.00 | $30.00 | $30.00 |
Breast prosthesis, mastectomy sleeve
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $58.33 | $61.22 | $73.34 | |
Medica
| Facility | $100.00 | $146.91 | $146.91 | |
Medica
| Professional | $51.46 | $194.36 | $194.36 | |
United
| Facility | $30.00 | $30.00 | $30.00 |