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Washington 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

Facilitymedian $5,623 · 10th–90th $1,905–$12,3030%20%10th90th$5,623Professionalmedian $10,715 · 10th–90th $1,950–$19,0550%20%40%10th90th$10,715$20.0$100.0$500.0$2.0K$10.0K$50.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10,715.19 / $10,715.19 / $15,135.61
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$18,620.87 / $18,620.87 / $18,620.87
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,778.28 / $21,877.62 / $23,988.33
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$13,182.57 / $13,182.57 / $13,182.57
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,621.81 / $11,220.18 / $13,182.57
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$14,125.38 / $14,125.38 / $14,125.38
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$14,125.38 / $14,125.38 / $14,125.38
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $2,137.96 / $11,220.18
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,089.30 / $12,302.69 / $12,302.69
Pacific Source
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,137.96 / $2,137.96 / $12,302.69
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,778.28 / $1,905.46 / $19,054.61
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,778.28 / $3,801.89 / $19,054.61
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,778.28 / $19,054.61 / $23,988.33
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$776.25 / $1,445.44 / $8,317.64
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5,754.40 / $6,165.95 / $11,748.98