go back

Utah 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
$847.52 / $847.52 / $847.52
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 / $3,588.75
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,050.87 / $1,853.15 / $2,937.92
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$847.52 / $1,302.91 / $2,060.05