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South Dakota rates for HCPCS E1050

Fully-Reclining Wheelchair Fixed Full Length Arms Swing Away Detachable Elevating Leg Rests (Special Coverage Instructions Apply. See Cim: 60-9)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$972.79 / $1,313.87 / $1,313.87
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$450.00 / $450.00 / $1,171.75
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,410.00 / $1,424.10 / $1,762.50
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$142.31 / $2,097.85 / $6,384.41
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$481.81 / $963.61 / $1,071.90
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$130.15 / $156.54 / $156.54
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$156.09 / $162.68 / $309.44
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$480.27 / $698.77 / $1,435.58