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Washington rates for HCPCS E2617

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

Facilitymedian $933 · 10th–90th $78–$9330%50%10th$933Professionalmedian $339 · 10th–90th $339–$3,7150%50%90th$339$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$338.84 / $338.84 / $3,715.35
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$407.38 / $407.38 / $416.87
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$346.74 / $346.74 / $407.38
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $72.44 / $93.33
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$77.62 / $933.25 / $933.25
Pacific Source
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $77.62 / $933.25