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Montana rates for HCPCS E2396

Power wheelchair accessory, caster fork, any size, replacement only, each

Insurance Carrier
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.39 / $7.39 / $7.39
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$42.67 / $42.67 / $71.47
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.67 / $59.36 / $71.47
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$26.47 / $68.06 / $94.98
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.67 / $59.36 / $71.47
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.27 / $30.27 / $50.45