go back

Louisiana rates for HCPCS E2617

Custom fabricated wheelchair back cushion, any size, including any type mounting hardware

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$336.05 / $336.05 / $1,690.00
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,510.31 / $1,510.31 / $1,510.31
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 / $750.00