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Indiana rates for HCPCS E2387

Power Wheelchair Accessory Foam Filled Caster Tire Any Size Replacement Only Each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$41.94 / $41.94 / $41.94
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$34.13 / $41.94 / $42.02
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$50.50 / $57.21 / $63.92
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.32 / $59.83 / $78.97
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.39 / $50.34 / $89.39
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.43 / $50.34 / $85.32
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$39.01 / $39.01 / $39.01
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.15 / $39.01 / $77.53
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.64 / $33.57 / $60.23