go back

Minnesota rates for HCPCS E1011

Modification to pediatric size wheelchair, width adjustment package (not to be dispensed with initial chair)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$574.00 / $574.00 / $574.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$574.00 / $574.00 / $574.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$424.00 / $424.00 / $919.75
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$366.38 / $386.81 / $465.30
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$650.61 / $650.61 / $724.21
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$366.38 / $366.38 / $366.38
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$574.00 / $574.00 / $1,423.10
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$535.44 / $548.40 / $842.16