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Maryland 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
Professional
Modifier
Low / Median / High Price
$8,135.84 / $11,108.18 / $15,139.44
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15,709.38 / $15,709.38 / $15,709.40
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13,275.38 / $13,275.38 / $13,275.38
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,527.46 / $11,284.07 / $13,275.38
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16,028.82 / $16,028.82 / $16,028.82
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,062.03 / $7,188.04 / $11,398.27
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13,791.74 / $13,791.74 / $18,370.20