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Pennsylvania 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
$5,478.92 / $11,354.58 / $14,193.23
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10,971.04 / $14,408.00 / $14,408.00
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
$7,056.00 / $11,284.07 / $25,053.75
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,478.92 / $11,608.03 / $14,224.74
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,568.60 / $13,275.38 / $13,275.38
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,603.83 / $13,275.38 / $31,317.19
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11,687.78 / $20,570.70 / $20,570.70
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,056.96 / $7,188.04 / $11,980.07