go back

Nebraska rates for HCPCS E1222

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$691.82 / $691.82 / $691.82
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$717.99 / $775.10 / $815.89
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$779.66 / $783.07 / $783.07
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$624.15 / $783.07 / $1,335.94
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$67.59 / $691.82 / $4,248.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$227.71 / $362.17 / $541.41
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$91.62 / $104.16 / $175.62
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$104.16 / $121.68 / $246.19
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$231.33 / $362.17 / $603.62