go back

Utah rates for HCPCS K0863

Power wheelchair, group 3 very heavy-duty, multiple power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6,760.83 / $13,803.84 / $14,125.38
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11,220.18 / $11,220.18 / $11,220.18
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,288.25 / $11,220.18 / $20,892.96
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,073.80 / $7,244.36 / $8,912.51
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12,022.64 / $12,302.69 / $12,302.69
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,230.27 / $1,862.09 / $11,220.18
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$616.60 / $1,230.27 / $8,128.31
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,380.38 / $5,128.61 / $10,000.00