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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 October 2026.

How much does HCPCS K0859 cost?

$6,310

Typical negotiated rate. In Pennsylvania, October 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 $7,413 from a hospital or other facility.

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 8 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$6,310$6,310 to $7,762
FacilityA hospital or hospital-owned outpatient department$7,413$7,413 to $25,704

How much rates vary

Facilitymedian $7,413 · 10th to 90th $6,310 to $39,811Professionalmedian $6,310 · 10th to 90th $4,074 to $11,482
$5K$10K$20K$50Kfacility $7,413professional $6,310

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$6,309.57
Median
$6,760.83
Typical High
$6,760.83
Aetna
Setting
Professional
Modifier
None
Typical Low
$6,309.57
Median
$6,309.57
Typical High
$6,760.83
Aetna
Setting
Professional
Modifier
UE · Used equipment
Typical Low
$4,786.30
Median
$4,786.30
Typical High
$5,011.87
Capital Blue Cross
Setting
Facility
Modifier
None
Typical Low
$4,265.80
Median
$5,011.87
Typical High
$79,432.82
Capital Blue Cross
Setting
Professional
Modifier
None
Typical Low
$6,165.95
Median
$6,165.95
Typical High
$8,128.31
Cigna
Setting
Facility
Modifier
None
Typical Low
$7,413.10
Median
$7,413.10
Typical High
$7,413.10
Cigna
Setting
Facility
Modifier
RR · Rental
Typical Low
$741.31
Median
$741.31
Typical High
$741.31
Cigna
Setting
Professional
Modifier
None
Typical Low
$6,309.57
Median
$7,413.10
Typical High
$7,413.10
Cigna
Setting
Professional
Modifier
RR · Rental
Typical Low
$630.96
Median
$630.96
Typical High
$741.31
Emblem Health
Setting
Professional
Modifier
RR · Rental
Typical Low
$1,148.15
Median
$1,148.15
Typical High
$1,230.27
Geisinger
Setting
Facility
Modifier
RR · Rental
Typical Low
$1,230.27
Median
$1,230.27
Typical High
$1,230.27
Geisinger
Setting
Professional
Modifier
None
Typical Low
$7,762.47
Median
$7,762.47
Typical High
$9,549.93
Geisinger
Setting
Professional
Modifier
RR · Rental
Typical Low
$741.31
Median
$870.96
Typical High
$1,230.27
Geisinger
Setting
Professional
Modifier
UE · Used equipment
Typical Low
$3,801.89
Median
$3,801.89
Typical High
$4,677.35
Martin's Point
Setting
Facility
Modifier
None
Typical Low
$6,760.83
Median
$6,760.83
Typical High
$6,760.83
Martin's Point
Setting
Professional
Modifier
None
Typical Low
$6,309.57
Median
$6,309.57
Typical High
$6,760.83
Martin's Point
Setting
Professional
Modifier
UE · Used equipment
Typical Low
$4,786.30
Median
$4,786.30
Typical High
$5,011.87
UPMC Health Plan
Setting
Facility
Modifier
None
Typical Low
$6,309.57
Median
$28,183.83
Typical High
$48,977.88
UPMC Health Plan
Setting
Facility
Modifier
RR · Rental
Typical Low
$660.69
Median
$3,981.07
Typical High
$6,760.83
UPMC Health Plan
Setting
Professional
Modifier
None
Typical Low
$6,309.57
Median
$11,481.54
Typical High
$11,481.54
UPMC Health Plan
Setting
Professional
Modifier
RR · Rental
Typical Low
$660.69
Median
$891.25
Typical High
$891.25
United
Setting
Professional
Modifier
None
Typical Low
$2,691.53
Median
$4,073.80
Typical High
$5,754.40
United
Setting
Professional
Modifier
RR · Rental
Typical Low
$363.08
Median
$602.56
Typical High
$812.83

Where Pennsylvania sits

The same service costs 10.7 times more in North Dakota than in Mississippi. 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· 33rd of 51

$6,310

ND $13,804MS $1,288

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.