go back

South Dakota rates for HCPCS E2391

Power Wheelchair Accessory Solid (Rubber/Plastic)Caster Tire (Removable) Any Size Replacement Only Each

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.25 / $19.73 / $19.73
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13.81 / $13.81 / $26.21
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.63 / $26.21 / $29.53
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19.57 / $44.53 / $99.12
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.83 / $17.39 / $22.98
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.60 / $2.63 / $2.63
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.60 / $4.96 / $27.12
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.80 / $12.18 / $20.49
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.45 / $21.45 / $21.45