go back

Texas 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 / $12,679.28 / $16,842.63
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14,408.00 / $14,408.00 / $14,408.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13,275.38 / $13,275.38 / $14,056.65
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,603.83 / $13,275.38 / $13,275.38
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $14,509.39 / $14,509.39
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,135.84 / $13,144.38 / $15,222.32
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,988.30 / $2,161.19 / $16,915.30
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,135.84 / $13,144.38 / $14,408.01
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
$5,091.54 / $6,645.96 / $9,940.00
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13,791.74 / $15,910.41 / $15,910.41