go back

Washington 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
$659.35 / $684.30 / $917.01
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$119.87 / $6,143.69 / $6,143.69
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$743.01 / $891.22 / $1,437.45
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$840.94 / $840.94 / $840.94
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$101.59 / $714.80 / $840.94
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.00 / $136.90 / $136.90
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,909.05 / $2,293.01 / $2,325.57
Pacific Source
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,909.05 / $2,293.01 / $2,325.57
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$119.87 / $119.87 / $119.87
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$241.06 / $1,296.79 / $2,410.55
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$92.42 / $92.42 / $112.53
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$460.53 / $575.99 / $959.98
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$711.08 / $711.08 / $711.08