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Pennsylvania rates for HCPCS E0953

Wheelchair Accessory Lateral Thigh Or Knee Support Any Type Including Fixed Mounting Hardware Each (Reinstated Code) Old Description: Pneumatic Tire Each (Not Valid For Medicare) (Deleted 12/31/05)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$34.63 / $49.47 / $65.34
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.71 / $87.14 / $87.14
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$64.23 / $64.23 / $79.36
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.60 / $54.60 / $138.75
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$80.17 / $80.17 / $87.14
Highmark BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.00 / $90.88 / $98.97
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.71 / $63.45 / $114.06
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$64.23 / $64.23 / $79.36
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.60 / $71.44 / $138.75
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$76.88 / $89.85 / $95.18
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.64 / $56.90 / $103.47