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Maine rates for HCPCS E2204

Manual Wheelchair Accessory Nonstandard Seat Frame Depth 22 To 25 Inches

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$620.87 / $620.87 / $829.66
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$815.66 / $967.16 / $1,792.81
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$648.95 / $659.97 / $699.76
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$581.42 / $581.42 / $927.26
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$561.25 / $581.42 / $705.09
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$670.72 / $670.72 / $670.72
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$477.80 / $620.87 / $829.66
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$325.95 / $556.99 / $1,205.95