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Utah rates for HCPCS E2617

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

Facilitymedian $407 · 10th–90th $407–$4070%50%100%$407Professionalmedian $363 · 10th–90th $339–$7590%20%10th90th$363$50.0$100.0$200.0$500.0$1.0K$2.0K

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
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$338.84 / $363.08 / $691.83
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$407.38 / $407.38 / $407.38
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$346.74 / $407.38 / $758.58
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$44.67 / $44.67 / $60.26
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$794.33 / $794.33 / $794.33