go back

South Dakota rates for HCPCS E2388

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.43 / $53.74 / $53.74
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$37.90 / $37.90 / $65.23
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.13 / $67.80 / $83.91
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$48.11 / $110.78 / $272.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$24.17 / $48.03 / $55.85
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.48 / $6.53 / $6.53
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.48 / $12.32 / $67.48
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.51 / $34.90 / $55.85
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$53.38 / $53.38 / $53.38