go back

Montana rates for HCPCS E2217

Manual wheelchair accessory, foam filled caster tire, any size, each

Insurance Carrier
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.78 / $5.78 / $5.78
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$31.91 / $31.91 / $58.34
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31.91 / $58.34 / $58.34
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$31.91 / $46.76 / $58.45
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31.91 / $39.89 / $58.34
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.79 / $22.79 / $37.97