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New Hampshire rates for HCPCS E2386

Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$59.29 / $71.25 / $76.20
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$106.08 / $106.08 / $106.08
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$98.51 / $98.51 / $106.39
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 / $101.12
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$84.77 / $237.96 / $301.60
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$41.00 / $76.93 / $127.93
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$116.30 / $128.85 / $164.00