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Massachusetts 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
$9,442.95 / $9,442.95 / $9,442.95
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9,086.28 / $9,442.95 / $11,331.50
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11,276.87 / $11,964.50 / $14,509.39
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,791.65 / $9,690.20 / $11,824.07
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,504.06 / $2,504.06 / $2,577.08
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11,084.58 / $14,844.01 / $14,844.01
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13,275.38 / $13,275.38 / $14,056.65
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,603.83 / $13,275.38 / $31,317.19
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17,623.63 / $17,623.63 / $17,623.63
Health New England
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9,571.60 / $9,571.60 / $9,571.60
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $14,509.39 / $14,509.39
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,792.03 / $7,188.04 / $10,971.04
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,485.52 / $7,267.65 / $17,623.63