go back

Power Wheelchair Foam Caster Tire, Replacement

South Dakota rates for HCPCS E2389

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

Rates data updated July 2026.

Facilitymedian $21 · 10th–90th $2$1510%10%10th90th$21Professionalmedian $30 · 10th–90th $13$380%20%10th90th$30$2.0$5.0$10.0$20.0$50.0$100.0

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
Aetna
Setting
Professional
Modifier
Global
Typical Low
$22.39
Median
$29.51
Typical High
$29.51
Cigna
Setting
Facility
Modifier
Global
Typical Low
$21.38
Median
$21.38
Typical High
$37.15
Cigna
Setting
Professional
Modifier
Global
Typical Low
$37.15
Median
$37.15
Typical High
$46.77
Medica
Setting
Facility
Modifier
Global
Typical Low
$26.30
Median
$38.02
Typical High
$151.36
Medica
Setting
Professional
Modifier
Global
Typical Low
$13.18
Median
$18.62
Typical High
$30.90
Midlands
Setting
Professional
Modifier
Global
Typical Low
$29.51
Median
$35.48
Typical High
$36.31
Midlands
Setting
Facility
Modifier
Global
Typical Low
$37.15
Median
$37.15
Typical High
$37.15
United
Setting
Facility
Modifier
Global
Typical Low
$1.86
Median
$14.45
Typical High
$26.92
United
Setting
Professional
Modifier
Global
Typical Low
$12.59
Median
$26.30
Typical High
$38.02
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$30.20
Median
$30.20
Typical High
$30.20