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Power Wheelchair Foam Caster Tire, Replacement

Hawaii rates for HCPCS E2389

Power wheelchair accessory, foam caster tire, any size, replacement only, each

Rates data updated July 2026.

Facilitymedian $14 · 10th–90th $2$250%10%10th90th$14Professionalmedian $33 · 10th–90th $21$430%20%10th90th$33$2.0$5.0$10.0$20.0$50.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample; interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Cigna
Setting
Facility
Modifier
Global
Typical Low
$21.38
Median
$21.38
Typical High
$26.30
Cigna
Setting
Professional
Modifier
Global
Typical Low
$21.38
Median
$25.70
Typical High
$36.31
HMSA
Setting
Professional
Modifier
Global
Typical Low
$34.67
Median
$35.48
Typical High
$44.67
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$23.44
Median
$30.20
Typical High
$46.77
United
Setting
Facility
Modifier
Global
Typical Low
$1.38
Median
$13.80
Typical High
$24.55
United
Setting
Professional
Modifier
Global
Typical Low
$15.14
Median
$26.92
Typical High
$36.31