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Utah rates for HCPCS E2612

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

Facilitymedian $195 · 10th–90th $19–$2570%20%10th90th$195Professionalmedian $288 · 10th–90th $40–$1,5490%10%20%10th90th$288$5.0$20.0$100.0$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $229.09 / $1,548.82
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$245.47 / $245.47 / $245.47
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$208.93 / $245.47 / $426.58
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $239.88 / $346.74
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$323.59 / $380.19 / $489.78
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$371.54 / $380.19 / $467.74
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $45.71 / $398.11
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$19.50 / $147.91 / $257.04
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$27.54 / $199.53 / $363.08