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Texas 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 Texas, 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$2,630 to $6,918
FacilityA hospital or hospital-owned outpatient department$7,413$6,026 to $8,318

How much rates vary

Facilitymedian $7,413 · 10th to 90th $4,571 to $8,318Professionalmedian $6,310 · 10th to 90th $646 to $7,762
$100$200$500$1K$2K$5K$10Kfacility $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
$5,888.44
Median
$6,309.57
Typical High
$9,549.93
Aetna
Setting
Professional
Modifier
None
Typical Low
$5,888.44
Median
$7,079.46
Typical High
$9,549.93
Christus
Setting
Facility
Modifier
None
Typical Low
$8,317.64
Median
$8,317.64
Typical High
$8,317.64
Christus
Setting
Facility
Modifier
RR · Rental
Typical Low
$489.78
Median
$489.78
Typical High
$1,230.27
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
$741.31
Typical High
$741.31
Moda Health
Setting
Facility
Modifier
None
Typical Low
$4,365.16
Median
$6,760.83
Typical High
$8,511.38
Moda Health
Setting
Professional
Modifier
None
Typical Low
$5,754.40
Median
$6,760.83
Typical High
$9,549.93
Molina
Setting
Professional
Modifier
None
Typical Low
$81.28
Median
$645.65
Typical High
$6,456.54
Providence
Setting
Facility
Modifier
None
Typical Low
$4,570.88
Median
$7,413.10
Typical High
$8,317.64
Providence
Setting
Facility
Modifier
RR · Rental
Typical Low
$741.31
Median
$741.31
Typical High
$741.31
Providence
Setting
Professional
Modifier
None
Typical Low
$6,309.57
Median
$7,413.10
Typical High
$7,413.10
Providence
Setting
Professional
Modifier
RR · Rental
Typical Low
$630.96
Median
$741.31
Typical High
$741.31
United
Setting
Professional
Modifier
None
Typical Low
$2,344.23
Median
$3,162.28
Typical High
$4,365.16
United
Setting
Professional
Modifier
RR · Rental
Typical Low
$234.42
Median
$426.58
Typical High
$588.84
Wellpoint
Setting
Professional
Modifier
None
Typical Low
$7,762.47
Median
$8,912.51
Typical High
$8,912.51
2 more rates with less common billing modifiers

A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.

Insurance Carrier
Aetna
Setting
Professional
Modifier
UE · Used equipment
Typical Low
$4,466.84
Median
$5,248.07
Typical High
$7,079.46
Moda Health
Setting
Professional
Modifier
UE · Used equipment
Typical Low
$4,466.84
Median
$5,128.61
Typical High
$7,079.46

Where Texas 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.

Texas· 34th 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.