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Minnesota rates for HCPCS K0195

Elevating Leg Rests Pair (For Use With Capped Rental Wheelchair Base) (Special Coverage Instructions Apply. See Cim: 60-9)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$97.97 / $97.97 / $97.97
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$76.45 / $97.97 / $118.13
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$154.68 / $192.80 / $220.12
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$154.72 / $193.42 / $208.20
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$83.00 / $88.70 / $336.91
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$157.50 / $163.80 / $200.03
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$238.32 / $238.32 / $265.27
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$157.50 / $157.50 / $157.50
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$22.84 / $26.65 / $118.13
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.74 / $8.52 / $106.35
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.74 / $8.75 / $106.35