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Pennsylvania 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
$2,303.40 / $3,726.18 / $4,632.57
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,400.48 / $7,092.30 / $7,092.30
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
$4,340.22 / $5,106.14 / $10,373.44
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,303.40 / $3,726.18 / $4,695.60
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,106.14 / $5,106.14 / $5,106.14
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$616.89 / $5,106.14 / $10,373.44
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,851.09 / $6,750.60 / $6,812.60
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,968.56 / $2,762.85 / $7,062.18