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Iowa rates for HCPCS E1172

Amputee Wheelchair Detachable Arms (Desk Or Full Length) Without Footrests Or Legrest (Special Coverage Instructions Apply. See Cim: 60-9)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$820.89 / $820.89 / $846.56
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$419.23 / $685.63 / $963.61
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$840.94 / $840.94 / $1,127.58
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$101.59 / $1,586.25 / $1,982.81
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$112.71 / $112.71 / $1,010.49
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$120.37 / $1,352.32 / $6,143.69
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$383.78 / $575.66 / $1,430.73
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$128.01 / $130.26 / $307.89
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$127.63 / $155.97 / $297.67
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$469.55 / $557.04 / $1,430.73