go back

Montana rates for HCPCS E1195

Heavy-duty wheelchair, fixed full-length arms, swing-away detachable elevating legrests

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,202.26 / $1,202.26 / $1,202.26
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$123.03 / $123.03 / $1,548.82
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$104.71 / $173.78 / $1,258.93
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.43 / $123.03 / $2,187.76
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$58.88 / $588.84 / $1,174.90
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$588.84 / $741.31 / $741.31