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Montana rates for HCPCS E1233

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

Insurance Carrier
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$302.31 / $302.31 / $302.31
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
$218.80 / $1,406.76 / $2,326.52
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$309.57 / $1,506.70 / $3,722.43
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$218.80 / $1,406.76 / $2,326.52
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,186.52 / $1,302.91 / $2,171.51