go back

Maine 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
$607.84 / $607.84 / $607.84
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$953.88 / $1,131.05 / $2,096.61
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$681.69 / $681.69 / $681.69
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 / $711.17
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$784.38 / $784.38 / $784.38
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$449.11 / $449.11 / $607.84
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$340.85 / $511.27 / $1,182.14