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Custom Fabricated Wheelchair Back Cushion

North Dakota 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?

$339

Typical facility fee. In North Dakota, October 2026.

Insurers have agreed to pay about $339 for this service. Most negotiated rates run $339 to $759.

Few insurers publish rates for this combination, so treat this figure as a rough guide.

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 3 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $339 · 10th to 90th $339 to $575Professionalmedian $759 · 10th to 90th $339 to $955
$500$1K$2Kfacility $339professional $759

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

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$338.84
Median
$338.84
Typical High
$338.84
Aetna
Setting
Professional
Modifier
None
Typical Low
$338.84
Median
$338.84
Typical High
$3,715.35
Cigna
Setting
Facility
Modifier
None
Typical Low
$407.38
Median
$407.38
Typical High
$416.87
Cigna
Setting
Professional
Modifier
None
Typical Low
$758.58
Median
$758.58
Typical High
$933.25
Medica
Setting
Facility
Modifier
None
Typical Low
$338.84
Median
$338.84
Typical High
$1,000.00

Where North Dakota 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.

North Dakota· 43rd of 51

$339

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.