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Wisconsin rates for HCPCS E0969

Narrowing Device Wheelchair (Special Coverage Instructions Apply. See Cim: 60-9)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$142.09 / $142.09 / $142.09
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$92.07 / $131.22 / $172.46
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$213.50 / $388.57 / $388.57
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$198.33 / $198.56 / $288.22
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.35 / $115.06 / $456.38
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$134.41 / $134.41 / $588.42
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$134.41 / $253.88 / $317.33
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$59.91 / $142.09 / $255.76
DeanCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$125.30 / $125.30 / $255.91
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$59.91 / $255.91 / $997.78
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.80 / $108.27 / $243.74
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.00 / $65.00 / $120.52
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$59.91 / $142.09 / $255.76
Prevea360
Facility/Professional
Professional
Modifier
Low / Median / High Price
$125.30 / $125.30 / $255.91
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.18 / $43.38 / $56.33
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$134.41 / $416.52 / $997.78
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$134.41 / $134.41 / $154.66
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$213.26 / $213.26 / $213.26
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$213.26 / $213.26 / $213.26
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$77.34 / $122.63 / $218.84