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Minnesota 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
$557.49 / $557.49 / $557.49
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$522.49 / $557.49 / $644.04
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$945.50 / $1,076.53 / $1,083.41
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$770.38 / $962.97 / $1,036.57
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$369.39 / $369.39 / $2,254.73
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,046.63 / $1,057.08 / $1,329.21
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,594.96 / $1,594.96 / $1,775.39
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,046.63 / $1,046.63 / $1,046.63
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$640.58 / $1,036.57 / $4,343.22
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$290.27 / $486.22 / $990.58
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$290.27 / $484.19 / $926.56