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Oklahoma 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
Professional
Modifier
Low / Median / High Price
$419.23 / $719.22 / $899.03
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 / $1,586.25
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$93.70 / $525.39 / $6,143.69
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$383.99 / $575.50 / $910.71
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$423.95 / $537.13 / $828.48