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Michigan rates for HCPCS E2386

Power Wheelchair Accessory Foam Filled Drive Wheel Tire Any Size Replacement Only Each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$105.50 / $105.50 / $105.50
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.04 / $92.28 / $105.50
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$460.43 / $460.43 / $602.94
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.93 / $94.16 / $169.49
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.36 / $81.61 / $117.81
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.05 / $75.34 / $144.99
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$81.17 / $81.17 / $81.17
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.75 / $81.17 / $114.51
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.10 / $100.44 / $163.11
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31.03 / $56.73 / $66.75
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$51.25 / $86.64 / $126.43