go back

Nebraska rates for HCPCS E2375

Power wheelchair accessory, nonexpandable controller, including all related electronics and mounting hardware, replacement only

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$709.22 / $709.22 / $709.22
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$688.50 / $743.27 / $782.39
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$407.96 / $407.96 / $545.22
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$407.96 / $566.82 / $1,118.29
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$103.12 / $709.22 / $2,957.66
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$219.27 / $436.85 / $782.04
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$104.37 / $105.14 / $198.47
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$105.14 / $129.78 / $248.51
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$312.45 / $436.85 / $726.26