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Pennsylvania 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
$4,169.49 / $8,640.90 / $10,801.13
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,644.69 / $8,349.02 / $10,964.60
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10,102.62 / $10,102.62 / $10,102.62
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7,056.00 / $8,587.24 / $19,068.75
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,169.49 / $8,833.77 / $10,825.13
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10,102.62 / $10,102.62 / $10,102.62
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,220.52 / $10,102.62 / $23,835.94
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8,467.74 / $15,654.40 / $15,654.40
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,646.75 / $5,470.12 / $9,116.87