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Indiana rates for HCPCS E1200

Amputee wheelchair, fixed full-length arms, swing-away detachable footrest

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$752.12 / $752.12 / $752.12
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$555.01 / $694.26 / $757.59
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$443.80 / $660.00 / $837.54
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$77.50 / $158.04 / $1,602.72
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.02 / $145.88 / $1,923.26
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$746.73 / $746.73 / $746.73
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.92 / $746.73 / $882.34
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$341.12 / $465.63 / $681.28