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Power Wheelchair, Group 4 Standard, Single Power Option

Massachusetts 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

Rates data updated July 2026.

How much does Power Wheelchair, Group 4 Standard, Single Power Option cost?

$5,129

Typical facility fee. In Massachusetts, July 2026.

Insurers have agreed to pay about $5,129 for this service. Most negotiated rates run $5,129 to $5,129.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 5 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $5,129 · 10th to 90th $5,129 to $5,754Professionalmedian $5,129 · 10th to 90th $5,129 to $5,129
$100$200$500$1K$2K$5Kfacility $5,129professional $5,129

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$5,128.61
Median
$5,128.61
Typical High
$5,128.61
Aetna
Setting
Professional
Modifier
Global
Typical Low
$5,128.61
Median
$5,128.61
Typical High
$5,128.61
AllWays Health Partners
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
BCBS
Setting
Facility
Modifier
Global
Typical Low
$5,754.40
Median
$5,754.40
Typical High
$5,888.44
Cigna
Setting
Professional
Modifier
Global
Typical Low
$5,623.41
Median
$5,623.41
Typical High
$7,079.46
Mass General Brigham
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$100.00

Where Massachusetts sits

The same service costs 1.7 times more in Wyoming than in Minnesota. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Massachusetts· 40th of 50

$5,129

WY $6,918MN $4,169

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.