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South Dakota rates for HCPCS E2377

Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$191.35 / $390.32 / $519.24
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$382.62 / $382.62 / $562.65
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$648.75 / $655.24 / $810.94
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$463.76 / $1,069.48 / $3,065.64
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$232.95 / $464.00 / $539.05
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$62.49 / $62.99 / $62.99
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$62.49 / $118.80 / $651.41
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$217.60 / $278.39 / $465.90
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$515.34 / $515.34 / $515.34