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Montana rates for HCPCS E2612

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

Facilitymedian $389 · 10th–90th $195–$4790%20%10th90th$389Professionalmedian $295 · 10th–90th $162–$4790%10%20%10th90th$295$20.0$50.0$100.0$200.0$500.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $288.40 / $691.83
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$245.47 / $478.63 / $478.63
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$245.47 / $478.63 / $478.63
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$316.23 / $389.05 / $446.68
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$316.23 / $389.05 / $446.68
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$245.47 / $478.63 / $707.95
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $316.23 / $478.63
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$19.50 / $162.18 / $257.04
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $186.21 / $309.03