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Wisconsin rates for HCPCS E2612

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

Facilitymedian $380 · 10th–90th $39–$1,0000%10%10th90th$380Professionalmedian $275 · 10th–90th $195–$4470%20%10th90th$275$20.0$50.0$100.0$200.0$500.0$1.0K

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
Facility
Modifier
Typical Low / Median / Typical High
$263.03 / $263.03 / $263.03
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$194.98 / $245.47 / $263.03
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$380.19 / $691.83 / $691.83
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$323.59 / $380.19 / $512.86
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$245.47 / $323.59 / $1,513.56
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$245.47 / $467.74 / $724.44
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$234.42 / $407.38 / $588.84
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$338.84 / $338.84 / $338.84
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$234.42 / $588.84 / $1,737.80
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$199.53 / $275.42 / $457.09
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $64.57 / $338.84
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$251.19 / $389.05 / $645.65
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $79.43 / $104.71
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$245.47 / $741.31 / $1,737.80
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$208.93 / $245.47 / $295.12
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$21.88 / $169.82 / $288.40
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$169.82 / $263.03 / $467.74