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New Hampshire rates for HCPCS K0011

Standard-weight frame motorized/power wheelchair with programmable control parameters for speed adjustment, tremor dampening, acceleration control and braking

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,009.16 / $3,912.49 / $3,912.49
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,969.71 / $4,969.71 / $4,969.71
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,106.14 / $5,106.14 / $5,106.14
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$560.27 / $4,340.22 / $5,106.14
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,587.01 / $2,380.52 / $4,430.39
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,622.52 / $6,229.63 / $7,928.62