go back

Michigan rates for HCPCS E2628

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$705.45 / $705.45 / $705.45
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$476.27 / $705.45 / $787.20
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,286.67 / $3,286.67 / $4,303.96
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$65.48 / $672.16 / $1,209.88
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$57.64 / $441.12 / $588.15
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.93 / $532.02 / $709.39
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$369.39 / $369.39 / $369.39
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$369.39 / $369.39 / $1,046.63
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$476.27 / $718.75 / $1,043.22
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$341.64 / $481.19 / $701.61