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Michigan rates for HCPCS K0858

Power wheelchair, group 3 heavy-duty, single power option, sling/solid seat/back, patient weight 301 to 450 pounds

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,679.92 / $9,679.92 / $9,679.92
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6,827.98 / $9,679.92 / $10,129.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,765.47 / $48,076.92 / $64,102.53
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$975.43 / $10,011.02 / $18,019.83
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$465.65 / $826.31 / $11,155.13
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,016.99 / $1,016.99 / $10,169.92
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,978.93 / $4,978.93 / $4,978.93
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$898.47 / $4,978.93 / $14,737.50
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,532.22 / $7,896.18 / $19,068.59
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$730.96 / $2,107.48 / $9,137.10
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,813.95 / $3,893.37 / $6,926.20