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Montana rates for HCPCS K0813

Power wheelchair, group 1 standard, portable, sling/solid seat and back, patient weight capacity up to and including 300 pounds

Insurance Carrier
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,225.09 / $2,225.09 / $2,225.09
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$246.17 / $2,225.09 / $2,894.88
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$164.04 / $317.68 / $3,493.12
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$246.17 / $2,225.09 / $2,894.88
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,106.56 / $1,106.56 / $1,844.27