go back

Montana rates for HCPCS E2222

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

Insurance Carrier
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.82 / $2.82 / $2.82
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$17.30 / $17.30 / $30.62
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.30 / $30.62 / $30.62
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.39 / $23.55 / $35.38
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.30 / $30.62 / $30.62
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.27 / $12.75 / $21.25