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Montana rates for HCPCS E2389

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

Facilitymedian $25 · 10th–90th $14$390%20%10th90th$25Professionalmedian $23 · 10th–90th $3$430%10%20%10th90th$23$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$22.91 / $22.91 / $52.48
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.39 / $3.39 / $3.39
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$21.38 / $34.67 / $34.67
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$21.38 / $34.67 / $34.67
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$20.42 / $25.12 / $38.90
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$20.42 / $25.12 / $38.90
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$10.96 / $33.88 / $45.71
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$25.12 / $34.67 / $79.43
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.38 / $13.80 / $24.55
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$14.79 / $15.85 / $24.55