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South Dakota rates for HCPCS E2224

Manual Wheelchair Accessory Propulsion Wheel Excludes Tire Any Size Replacement Only Each (Desc Revised 01/01/2017)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$88.54 / $109.83 / $109.83
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$95.86 / $95.86 / $142.86
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$132.38 / $142.86 / $165.47
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$93.63 / $149.63 / $523.65
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$49.22 / $86.29 / $103.20
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13.44 / $13.44 / $14.56
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.87 / $26.20 / $147.79
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.46 / $64.50 / $103.20
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$116.88 / $116.88 / $116.88