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Iowa rates for HCPCS E1233

Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,856.30 / $1,856.30 / $2,252.34
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$948.27 / $1,707.74 / $2,563.46
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,406.76 / $1,406.76 / $2,549.46
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,406.76 / $3,588.75 / $4,723.60
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$294.64 / $294.64 / $3,413.11
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$340.53 / $3,344.38 / $13,890.95
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,112.63 / $1,427.98 / $3,382.63
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$340.53 / $340.53 / $804.88
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$339.53 / $408.12 / $804.88
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,180.08 / $1,221.13 / $3,236.38
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,201.04 / $2,786.13 / $2,786.13