go back

Pennsylvania rates for HCPCS K0859

Power wheelchair, group 3 heavy-duty, single power option, captain's chair, patient weight capacity 301 to 450 pounds

Rates data updated July 2026.

How much does HCPCS K0859 cost?

$6,310

Typical negotiated rate. In Pennsylvania, July 2026.

Insurers have agreed to pay about $6,310 for this service. The price depends on where it is billed: about $6,310 from a physician practice, and about $5,129 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 7 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$6,310$4,074 to $6,761
FacilityA hospital or hospital-owned outpatient department$5,129$776 to $7,413

How much rates vary

Facilitymedian $5,129 · 10th to 90th $513 to $20,893Professionalmedian $6,310 · 10th to 90th $3,090 to $7,943
$500$1K$2K$5K$10K$20K$50Kfacility $5,129professional $6,310

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$3,090.30
Median
$6,309.57
Typical High
$7,413.10
Capital Blue Cross
Setting
Professional
Modifier
Global
Typical Low
$1,202.26
Median
$7,079.46
Typical High
$8,128.31
Cigna
Setting
Facility
Modifier
Global
Typical Low
$7,413.10
Median
$7,413.10
Typical High
$11,748.98
Cigna
Setting
Professional
Modifier
Global
Typical Low
$6,309.57
Median
$6,309.57
Typical High
$14,125.38
Geisinger
Setting
Professional
Modifier
Global
Typical Low
$7,762.47
Median
$7,762.47
Typical High
$9,549.93
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$3,981.07
Median
$6,760.83
Typical High
$7,413.10
UPMC Health Plan
Setting
Facility
Modifier
Global
Typical Low
$20,892.96
Median
$42,657.95
Typical High
$56,234.13
UPMC Health Plan
Setting
Professional
Modifier
Global
Typical Low
$11,481.54
Median
$11,481.54
Typical High
$11,481.54
United
Setting
Facility
Modifier
Global
Typical Low
$436.52
Median
$812.83
Typical High
$5,128.61
United
Setting
Professional
Modifier
Global
Typical Low
$2,691.53
Median
$4,073.80
Typical High
$7,079.46

Where Pennsylvania sits

The same service costs 2.5 times more in Minnesota than in Utah. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Pennsylvania· 35th of 51

$6,310

MN $11,482UT $4,571

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.