go back

Nebraska rates for HCPCS E1011

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

Insurance Carrier
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 / $424.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$366.38 / $424.00 / $457.97
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$574.00 / $591.22 / $1,423.10
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$574.00 / $574.00 / $574.00
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$421.04 / $421.04 / $483.99