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Connecticut rates for HCPCS K0877

Power wheelchair, group 4 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,128.61 / $5,128.61 / $5,128.61
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,786.30 / $5,248.07 / $5,248.07