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Pennsylvania rates for HCPCS E2204

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

Facilitymedian $437 · 10th–90th $51–$7240%10%10th90th$437Professionalmedian $490 · 10th–90th $380–$8510%20%10th90th$490$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$380.19 / $489.78 / $851.14
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$81.28 / $707.95 / $812.83
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 / $489.78 / $1,047.13
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$758.58 / $758.58 / $758.58
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$501.19 / $575.44 / $831.76
Highmark BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$562.34 / $676.08 / $676.08
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$380.19 / $489.78 / $575.44
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$812.83 / $812.83 / $851.14
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$43.65 / $389.05 / $616.60
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$309.03 / $478.63 / $870.96