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Indiana rates for HCPCS E1172

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$846.95 / $846.95 / $846.95
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$625.02 / $753.17 / $846.95
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$499.60 / $743.01 / $980.77
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$88.99 / $174.56 / $1,804.82
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$88.99 / $164.28 / $2,165.78
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$840.94 / $840.94 / $840.94
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$96.75 / $840.94 / $993.21
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$383.99 / $511.70 / $767.55