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Maine rates for HCPCS K0855

Power wheelchair, group 3 extra heavy-duty, captain's chair, patient weight capacity 601 pounds or more

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9,846.21 / $9,846.21 / $9,846.21
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8,071.90 / $10,495.50 / $10,495.50
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10,102.62 / $10,102.62 / $10,697.17
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,162.40 / $10,102.62 / $10,102.62
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13,411.64 / $13,411.64 / $13,411.64
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6,914.66 / $6,914.66 / $9,846.21
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,646.75 / $6,636.84 / $13,411.64