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Custom Fabricated Wheelchair Back Cushion

Missouri rates for HCPCS E2617

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

Rates data updated July 2026.

Facilitymedian $372 · 10th–90th $339$5130%20%40%10th90th$372Professionalmedian $339 · 10th–90th $339$6310%50%90th$339$100.0$200.0$500.0$1.0K$2.0K$5.0K

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
Setting
Professional
Modifier
Global
Typical Low
$338.84
Median
$338.84
Typical High
$338.84
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$50.12
Median
$630.96
Typical High
$758.58
Cigna
Setting
Facility
Modifier
Global
Typical Low
$407.38
Median
$407.38
Typical High
$602.56
Cigna
Setting
Professional
Modifier
Global
Typical Low
$346.74
Median
$346.74
Typical High
$407.38
Medica
Setting
Facility
Modifier
Global
Typical Low
$338.84
Median
$338.84
Typical High
$371.54
United
Setting
Professional
Modifier
Global
Typical Low
$794.33
Median
$794.33
Typical High
$794.33