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Maine rates for HCPCS E1233

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,853.35 / $1,853.35 / $2,392.92
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,936.05 / $1,936.05 / $2,279.06
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,406.76 / $1,406.76 / $3,020.16
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$218.80 / $1,406.76 / $1,956.94
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,524.46 / $2,524.46 / $2,524.46
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,301.55 / $1,853.35 / $2,392.92
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,011.49 / $1,873.82 / $3,344.76