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Iowa rates for HCPCS K0864

Power wheelchair, group 3 extra heavy-duty, multiple power option, sling/solid seat/back, patient weight capacity 601 pounds or more

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12,959.54 / $12,959.54 / $15,723.84
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6,620.02 / $11,922.31 / $17,896.50
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,568.60 / $13,275.38 / $13,275.38
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,603.83 / $25,053.75 / $31,317.19
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,057.07 / $2,057.07 / $17,842.91
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,575.75 / $14,509.39 / $25,115.55
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,649.08 / $7,188.04 / $19,685.65
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,777.04 / $3,110.57 / $5,619.12
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,560.19 / $2,970.66 / $5,619.12
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,982.40 / $7,188.04 / $19,685.65
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15,366.13 / $19,450.80 / $19,450.80