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New Hampshire rates for HCPCS E2204

Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 in

Facilitymedian $575 · 10th–90th $39–$8710%20%10th90th$575Professionalmedian $617 · 10th–90th $479–$7410%20%10th90th$617$50.0$100.0$200.0$500.0$1.0K$2.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$478.63 / $575.44 / $616.60
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$870.96 / $870.96 / $870.96
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$691.83 / $691.83 / $691.83
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$575.44 / $575.44 / $758.58
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$489.78 / $575.44 / $707.95
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$363.08 / $741.31 / $2,691.53
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$36.31 / $269.15 / $457.09
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$323.59 / $512.86 / $741.31
Well Sense
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$724.44 / $724.44 / $724.44