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Custom Fabricated Wheelchair Back Cushion

Utah 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 $407$4070%50%100%$407Professionalmedian $692 · 10th–90th $363$3,0200%20%10th90th$692$50.0$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. Small sample; interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$363.08
Median
$691.83
Typical High
$691.83
Cigna
Setting
Facility
Modifier
Global
Typical Low
$407.38
Median
$407.38
Typical High
$407.38
Cigna
Setting
Professional
Modifier
Global
Typical Low
$346.74
Median
$407.38
Typical High
$758.58
Molina
Setting
Professional
Modifier
Global
Typical Low
$44.67
Median
$44.67
Typical High
$60.26
Select Health
Setting
Professional
Modifier
Global
Typical Low
$2,511.89
Median
$5,011.87
Typical High
$7,079.46
United
Setting
Professional
Modifier
Global
Typical Low
$794.33
Median
$794.33
Typical High
$794.33