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Louisiana 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
$161.62 / $289.79 / $330.22
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$330.64 / $359.39 / $359.39
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$243.78 / $243.78 / $398.24
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$207.21 / $243.78 / $430.88
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$134.78 / $236.15 / $336.96