go back

Idaho rates for HCPCS E2389

Power Wheelchair Accessory Foam Caster Tire Any Size Replacement Only Each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$28.20 / $28.20 / $28.20
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.89 / $28.20 / $35.81
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$21.16 / $21.16 / $24.62
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.98 / $21.16 / $25.46
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.89 / $18.89 / $32.95
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.14 / $24.30 / $32.39
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.41 / $2.43 / $23.48
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$31.45 / $31.45 / $51.95
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.99 / $15.99 / $27.36