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Wisconsin rates for HCPCS E2604

Skin Protection Wheelchair Seat Cushion Width 22 Inches Or Greater Any Depth

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$123.98 / $123.98 / $123.98
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$78.39 / $112.91 / $147.11
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$174.20 / $317.04 / $317.04
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$161.97 / $174.17 / $236.82
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.32 / $122.44 / $372.72
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$115.51 / $115.51 / $473.09
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$115.51 / $205.50 / $256.88
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$123.98 / $181.53 / $260.95
DeanCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$150.72 / $150.72 / $272.29
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$123.98 / $272.29 / $829.11
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$90.40 / $122.88 / $227.81
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.00 / $65.00 / $165.71
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$123.98 / $185.97 / $260.95
Prevea360
Facility/Professional
Professional
Modifier
Low / Median / High Price
$150.72 / $150.72 / $272.29
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.99 / $38.65 / $50.19
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$115.51 / $338.20 / $829.11
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$115.51 / $115.51 / $151.61
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$208.45 / $208.45 / $208.45
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$208.45 / $208.45 / $208.45
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$77.40 / $122.39 / $216.84