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Utah rates for HCPCS E2389

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

Facilitymedian $15 · 10th–90th $1–$250%20%10th90th$15Professionalmedian $25 · 10th–90th $3–$1410%10%20%10th90th$25$0.5$2.0$10.0$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
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.00 / $22.91 / $141.25
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$21.38 / $21.38 / $21.38
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$17.78 / $21.38 / $37.15
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$14.45 / $21.38 / $30.90
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.84 / $33.11 / $35.48
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $33.11
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.45 / $3.98 / $33.11
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.48 / $10.96 / $24.55
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.51 / $15.85 / $31.62