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Virginia 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
$77.39 / $77.39 / $77.39
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$59.29 / $77.39 / $105.50
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$128.65 / $128.65 / $128.65
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$98.51 / $98.51 / $98.51
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$121.02 / $121.02 / $124.41
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$81.17 / $81.17 / $114.51
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$68.98 / $81.17 / $106.54
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$84.99 / $101.99 / $134.85
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$57.57 / $70.54 / $181.24
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$158.04 / $158.04 / $158.04
Sentara
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.94 / $72.23 / $160.47
Sentara
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.77 / $58.42 / $157.88
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.16 / $76.93 / $123.09