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Michigan 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
Facility
Modifier
Low / Median / High Price
$304.70 / $304.70 / $304.70
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$196.25 / $272.83 / $304.70
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$340.14 / $340.14 / $340.14
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,347.77 / $1,347.77 / $1,764.93
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.86 / $349.13 / $496.14
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$24.59 / $238.88 / $330.75
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.40 / $220.51 / $407.07
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$243.78 / $243.78 / $326.36
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$243.78 / $272.11 / $327.93
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.77 / $304.70 / $478.03
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.32 / $29.94 / $272.11
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$155.96 / $243.26 / $354.94