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Wisconsin rates for HCPCS E2617

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

Facilitymedian $372 · 10th–90th $65–$6030%10%20%10th90th$372Professionalmedian $339 · 10th–90th $339–$8510%50%90th$339$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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$338.84 / $338.84 / $338.84
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$338.84 / $338.84 / $660.69
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$630.96 / $1,905.46 / $1,905.46
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$407.38 / $416.87 / $3,388.44
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$346.74 / $851.14 / $954.99
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$338.84 / $338.84 / $602.56
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$338.84 / $371.54 / $501.19
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,445.44 / $1,445.44 / $1,445.44
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $54.95 / $89.13
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$64.57 / $371.54 / $407.38
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$346.74 / $407.38 / $416.87
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$794.33 / $933.25 / $933.25