go back

South Dakota rates for HCPCS E2395

Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.49 / $41.75 / $51.86
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$34.40 / $34.40 / $67.34
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.88 / $67.34 / $77.34
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$52.09 / $114.40 / $247.01
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.17 / $42.64 / $59.14
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.69 / $6.74 / $6.74
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.69 / $12.73 / $69.68
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.42 / $36.96 / $59.14
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55.11 / $55.11 / $55.11