go back

South Dakota rates for HCPCS E2383

Power wheelchair accessory, insert for pneumatic drive wheel tire (removable), any type, any size, replacement only, each

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$89.13 / $117.49 / $144.54
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $194.98
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$173.78 / $190.55 / $213.80
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$141.25 / $199.53 / $724.44
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$72.44 / $89.13 / $165.96
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$158.49 / $190.55 / $190.55
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$194.98 / $194.98 / $194.98
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.10 / $104.71 / $173.78
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$154.88 / $154.88 / $154.88