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New Hampshire rates for HCPCS E1250

Lightweight Wheelchair Fixed Full Length Arms Swing Away Detachable Footrest (Not Valid For Medicare)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$383.11 / $469.16 / $469.16
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$611.08 / $611.08 / $611.08
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$200.00 / $200.00 / $200.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$170.00 / $200.00 / $206.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$298.89 / $448.33 / $738.56
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$747.14 / $827.82 / $1,053.58