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Massachusetts 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
$35.51 / $35.51 / $35.51
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.59 / $35.51 / $42.61
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$53.36 / $100.00 / $280.00
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.99 / $52.58 / $57.63
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$67.48 / $67.48 / $67.48
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.51 / $47.51 / $59.53
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$39.01 / $39.01 / $63.33
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.15 / $39.01 / $84.38
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43.28 / $43.28 / $43.28
Health New England
Facility/Professional
Professional
Modifier
Low / Median / High Price
$53.99 / $53.99 / $53.99
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $280.00 / $280.00
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.69 / $36.58 / $60.74
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.69 / $43.28 / $72.67