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Custom Fabricated Wheelchair Back Cushion

South Dakota rates for HCPCS E2617

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

Rates data updated July 2026.

Facilitymedian $407 · 10th–90th $372$10,2330%10%20%10th90th$407Professionalmedian $759 · 10th–90th $339$3,7150%20%10th90th$759$500.0$1.0K$2.0K$5.0K$10.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample; interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$338.84
Median
$338.84
Typical High
$3,715.35
Cigna
Setting
Facility
Modifier
Global
Typical Low
$407.38
Median
$407.38
Typical High
$407.38
Cigna
Setting
Professional
Modifier
Global
Typical Low
$758.58
Median
$758.58
Typical High
$933.25
Medica
Setting
Facility
Modifier
Global
Typical Low
$371.54
Median
$6,309.57
Typical High
$10,232.93
Medica
Setting
Professional
Modifier
Global
Typical Low
$954.99
Median
$954.99
Typical High
$954.99
Midlands
Setting
Professional
Modifier
Global
Typical Low
$1,071.52
Median
$1,071.52
Typical High
$1,071.52
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$707.95
Median
$707.95
Typical High
$707.95