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New Mexico 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
$10,029.87 / $13,436.25 / $13,436.25
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 / $13,275.38 / $13,275.38
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,260.42 / $3,241.80 / $20,097.36
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,135.84 / $10,976.09 / $16,653.38
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,527.46 / $13,275.38 / $13,275.38
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,649.08 / $6,109.84 / $9,203.70