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Nebraska 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
$734.28 / $734.28 / $734.28
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$762.02 / $822.63 / $865.94
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$369.39 / $369.39 / $1,127.95
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$369.39 / $1,046.63 / $1,311.32
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$640.58 / $919.69 / $4,343.22
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$306.76 / $441.64 / $694.02
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$97.25 / $112.79 / $186.39
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$112.79 / $131.13 / $266.60
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$337.60 / $441.64 / $689.42