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Indiana 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
$1,915.23 / $1,915.23 / $1,915.23
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,662.71 / $1,915.23 / $2,033.03
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,090.41 / $2,090.41 / $2,090.41
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,329.44 / $2,279.06 / $2,848.82
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$216.70 / $402.44 / $4,179.20
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$201.22 / $371.48 / $5,015.03
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,406.76 / $1,406.76 / $1,406.76
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,195.75 / $1,406.76 / $2,559.17
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$868.60 / $1,302.91 / $1,991.79