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Indiana rates for HCPCS E2617

Custom Fabricated Wheelchair Back Cushion Any Size Including Any Type

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$336.05 / $336.05 / $336.05
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$336.05 / $336.05 / $3,694.91
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$811.99 / $811.99 / $811.99
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$510.00 / $637.50 / $841.50
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$405.00 / $405.00 / $413.10
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$344.25 / $405.00 / $417.15