| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $825.00 | $831.00 | $835.00 | |
BCBS
| Facility | $957.58 | $1,111.47 | $2,045.12 | |
Cigna
| Facility | $1,583.00 | $1,583.00 | $1,583.00 |
Other Therapeutic Services (see also 095X, an extension of 094X)-Complex Medical Equipment-Routine
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $825.00 | $831.00 | $835.00 | |
BCBS
| Facility | $957.58 | $1,111.47 | $2,045.12 | |
Cigna
| Facility | $1,583.00 | $1,583.00 | $1,583.00 |
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