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South Dakota rates for HCPCS E1223

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$706.93 / $901.62 / $901.62
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$422.72 / $422.72 / $851.77
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,061.25 / $1,071.85 / $1,326.56
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$103.41 / $1,202.14 / $4,640.93
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$350.10 / $700.19 / $779.16
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$89.32 / $107.43 / $113.42
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$111.63 / $117.82 / $224.88
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$349.12 / $435.24 / $779.16