go back

Montana rates for HCPCS E2221

Manual wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each

Insurance Carrier
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.37 / $3.37 / $3.37
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20.72 / $20.72 / $36.57
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.72 / $26.38 / $36.57
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20.72 / $28.07 / $42.21
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.72 / $26.38 / $36.57
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.69 / $15.28 / $25.46