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Wisconsin rates for HCPCS K0855

Power Wheelchair Group 3 Extra Heavy Duty Captains Chair Patient Weight Capacity 601 Poundsor More

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10,958.08 / $10,958.08 / $10,958.08
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6,919.86 / $9,862.27 / $12,961.35
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16,446.90 / $29,933.36 / $29,933.36
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8,071.90 / $15,295.62 / $20,558.62
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,183.19 / $1,183.19 / $3,519.64
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10,102.62 / $10,102.62 / $50,227.20
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8,587.24 / $19,068.75 / $23,835.94
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,191.44 / $10,958.08 / $16,437.12
DeanCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$728.41 / $728.41 / $13,157.53
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$80.00 / $10,964.61 / $16,437.12
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,940.68 / $5,470.12 / $12,212.17
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.15 / $55.00 / $10,707.60
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,191.44 / $10,958.08 / $16,437.12
Prevea360
Facility/Professional
Professional
Modifier
Low / Median / High Price
$728.41 / $728.41 / $13,157.53
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,847.06 / $3,288.51 / $4,269.89
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$65.00 / $10,102.62 / $11,041.73
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,162.40 / $10,102.62 / $10,102.62
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,874.67 / $5,470.12 / $10,964.60