go back

Kentucky 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
Facility
Modifier
Low / Median / High Price
$5,133.39 / $5,133.39 / $5,133.39
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,133.39 / $5,133.39 / $6,850.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,209.41 / $5,612.55 / $7,484.00
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$984.80 / $1,016.22 / $10,162.20
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$64.00 / $64.00 / $64.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00