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South Dakota rates for HCPCS E1221

Wheelchair With Fixed Arm Footrests (Special Coverage Instructions Apply. See Cim: 60-6)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$453.81 / $612.94 / $612.94
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$407.81 / $407.81 / $546.73
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$652.50 / $659.03 / $815.63
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$66.39 / $832.42 / $2,978.91
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$224.85 / $449.69 / $500.06
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$60.72 / $73.03 / $73.03
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$65.61 / $75.90 / $144.36
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$224.09 / $312.54 / $500.06