go back

Wisconsin rates for HCPCS E1223

Wheelchair with detachable arms, footrests

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$609.00 / $609.00 / $609.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$435.11 / $548.10 / $814.95
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$914.00 / $1,663.48 / $1,663.48
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$494.92 / $850.02 / $1,124.22
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$65.77 / $65.77 / $195.60
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$422.72 / $422.72 / $2,795.52
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$359.31 / $1,061.25 / $1,326.56
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$57.56 / $283.14 / $973.99
DeanCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$109.68 / $109.68 / $400.02
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$91.40 / $811.66 / $4,640.93
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$333.94 / $466.93 / $861.39
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.00 / $58.40 / $65.00
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$58.60 / $489.51 / $973.99
Prevea360
Facility/Professional
Professional
Modifier
Low / Median / High Price
$109.68 / $109.68 / $400.02
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$102.65 / $206.67 / $268.33
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$422.72 / $1,670.54 / $4,640.93
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$72.20 / $422.72 / $422.72
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$333.94 / $433.70 / $861.39