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Alaska rates for HCPCS E1172

Amputee wheelchair, detachable arms (desk or full-length) without footrests or legrest

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,734.15 / $1,734.15 / $1,734.15
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$840.94 / $840.94 / $840.94
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$714.80 / $840.94 / $840.94
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$419.23 / $719.10 / $1,090.59
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$130.06 / $157.35 / $157.35
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$133.41 / $1,315.70 / $3,535.37
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$476.27 / $764.18 / $1,042.40
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$714.80 / $840.94 / $840.94
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$643.96 / $1,234.25 / $2,253.85