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Tennessee 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
$13,504.50 / $13,504.50 / $13,504.50
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10,983.66 / $13,684.56 / $16,842.63
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13,520.59 / $17,019.45 / $20,423.34
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
$11,284.07 / $13,275.38 / $13,275.38
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$64.00 / $14,509.39 / $14,509.39
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,601.85 / $7,038.14 / $9,587.59