go back

New Hampshire 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
$9,086.28 / $11,922.31 / $11,922.31
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15,910.41 / $15,910.41 / $15,910.41
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
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17,623.63 / $49,471.29 / $62,703.11
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,601.85 / $7,123.92 / $9,266.64