go back

Montana rates for HCPCS E1015

Shock absorber for manual wheelchair, each

Insurance Carrier
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.39 / $15.39 / $15.39
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$93.52 / $93.52 / $166.04
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$93.52 / $120.44 / $166.04
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$93.52 / $128.22 / $192.70
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$93.52 / $120.44 / $166.04
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.42 / $68.65 / $114.41