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Maine rates for HCPCS E1190

Amputee Wheelchair Detachable Arms (Desk Or Full Length) Swing Away Detachable Elevating Legrests (Special Coverage Instructions Apply. See Cim: 60-9)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$884.74 / $884.74 / $884.74
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$887.98 / $1,022.92 / $1,022.92
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$115.61 / $115.61 / $1,140.20
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$598.64 / $598.64 / $884.74
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$458.83 / $688.24 / $1,767.57