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Power Wheelchair, Group 4 Standard, Single Power Option

Minnesota 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?

$4,169

Typical negotiated rate. In Minnesota, July 2026.

Insurers have agreed to pay about $4,169 for this service. The price depends on where it is billed: about $4,169 from a physician practice, and about $5,129 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

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 6 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$4,169$3,388 to $5,129
FacilityA hospital or hospital-owned outpatient department$5,129$4,169 to $5,129

How much rates vary

Facilitymedian $5,129 · 10th to 90th $4,169 to $13,490Professionalmedian $4,169 · 10th to 90th $417 to $5,623
$100.0$500.0$2.0K$10.0Kfacility $5,129professional $4,169

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
BCBS
Setting
Facility
Modifier
Global
Typical Low
$4,168.69
Median
$4,168.69
Typical High
$41,686.94
BCBS
Setting
Professional
Modifier
Global
Typical Low
$416.87
Median
$4,073.80
Typical High
$4,168.69
Cigna
Setting
Facility
Modifier
Global
Typical Low
$10,964.78
Median
$10,964.78
Typical High
$13,489.63
Cigna
Setting
Professional
Modifier
Global
Typical Low
$5,623.41
Median
$5,754.40
Typical High
$7,079.46
Health Partners
Setting
Facility
Modifier
Global
Typical Low
$9,549.93
Median
$9,549.93
Typical High
$10,715.19
Health Partners
Setting
Professional
Modifier
Global
Typical Low
$5,623.41
Median
$5,623.41
Typical High
$5,623.41
Medica
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$5,128.61
Typical High
$6,918.31
United
Setting
Professional
Modifier
Global
Typical Low
$398.11
Median
$436.52
Typical High
$831.76

Where Minnesota sits

The same service costs 1.7 times more in Wyoming than in Minnesota. Every bar is a state, most expensive first. Pick one to see its carriers and full range.

Minnesota $4,169 · 50th of 50
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.