go back

Minnesota 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
$38.13 / $38.13 / $38.13
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.59 / $38.13 / $45.14
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$67.00 / $69.91 / $76.65
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.39 / $75.48 / $81.26
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$39.01 / $39.01 / $145.71
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.50 / $68.18 / $85.73
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$103.07 / $103.07 / $114.73
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.50 / $67.50 / $67.50
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$25.82 / $81.26 / $280.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.64 / $32.97 / $82.89
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.64 / $32.97 / $67.04