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Alaska rates for HCPCS E2612

General use wheelchair back cushion, width 22 in or greater, any height, including any type mounting hardware

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$309.03 / $524.81 / $524.81
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$245.47 / $245.47 / $245.47
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$208.93 / $245.47 / $251.19
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$48.98 / $371.54 / $489.78
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$346.74 / $489.78 / $1,659.59
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$34.67 / $48.98 / $489.78
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$41.69 / $100.00 / $489.78
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$169.82 / $229.09 / $331.13
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.26 / $245.47 / $562.34
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19.50 / $147.91 / $257.04
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$245.47 / $478.63 / $870.96