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Custom Fabricated Wheelchair Back Cushion

Minnesota rates for HCPCS E2617

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

Rates data updated October 2026.

How much does Custom Fabricated Wheelchair Back Cushion cost?

$1,349

Typical negotiated rate. In Minnesota, October 2026.

Insurers have agreed to pay about $1,349 for this service. The price depends on where it is billed: about $776 from a physician practice, and about $3,715 from a hospital or other facility.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 5 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$776$759 to $3,715
FacilityA hospital or hospital-owned outpatient department$3,715$1,514 to $3,715

How much rates vary

Facilitymedian $3,715 · 10th to 90th $372 to $3,715Professionalmedian $776 · 10th to 90th $676 to $3,715
$500$1K$2K$5Kfacility $3,715professional $776

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$3,715.35
Median
$3,715.35
Typical High
$3,715.35
Aetna
Setting
Professional
Modifier
None
Typical Low
$3,715.35
Median
$3,715.35
Typical High
$3,715.35
Cigna
Setting
Facility
Modifier
None
Typical Low
$407.38
Median
$2,187.76
Typical High
$5,623.41
Cigna
Setting
Professional
Modifier
None
Typical Low
$660.69
Median
$758.58
Typical High
$954.99
Health Partners
Setting
Facility
Modifier
None
Typical Low
$1,412.54
Median
$2,238.72
Typical High
$5,248.07
Health Partners
Setting
Professional
Modifier
None
Typical Low
$660.69
Median
$758.58
Typical High
$758.58
Medica
Setting
Facility
Modifier
None
Typical Low
$338.84
Median
$371.54
Typical High
$1,096.48
Medica
Setting
Professional
Modifier
None
Typical Low
$426.58
Median
$1,819.70
Typical High
$6,025.60
1 more rate with less common billing modifiers

A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.

Insurance Carrier
BCBS Minnesota
Setting
Professional
Modifier
52 · Reduced service + 53 · Discontinued
Typical Low
$1,174.90
Median
$1,174.90
Typical High
$1,174.90

Where Minnesota sits

The same service costs 28.8 times more in Oklahoma than in Virginia. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Minnesota· 2nd of 51

$1,349

OK $1,820VA $63.10

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.