| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $95.00 | $95.00 | $95.00 | |
Cigna
| Facility | $64.00 | $64.00 | $64.00 | |
Cigna
| Professional | $0.80 | $0.80 | $0.80 | |
Molina
| Professional | $30.00 | $30.00 | $55.00 |
Unlisted Procedure For Miscellaneous Prosthetic Services
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $95.00 | $95.00 | $95.00 | |
Cigna
| Facility | $64.00 | $64.00 | $64.00 | |
Cigna
| Professional | $0.80 | $0.80 | $0.80 | |
Molina
| Professional | $30.00 | $30.00 | $55.00 |