go back

Louisiana rates for HCPCS E2628

Wheelchair Accessory Shoulder Elbow Mobile Arm Support Attached To Wheelchair Balanced Reclining

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$505.11 / $662.05 / $754.42
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$790.84 / $859.61 / $859.61
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$369.39 / $369.39 / $822.43
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$269.64 / $369.39 / $1,046.63
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$306.76 / $481.19 / $689.42