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Power Wheelchair, Group 4 Standard, Single Power Option

Montana 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 rates vary

Facilitymedian $7,586 · 10th to 90th $7,586 to $7,586Professionalmedian $6,918 · 10th to 90th $79 to $6,918
$100.0$200.0$500.0$1.0K$2.0K$5.0Kfacility $7,586professional $6,918

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. Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$6,918.31
Median
$6,918.31
Typical High
$6,918.31
Providence
Setting
Facility
Modifier
Global
Typical Low
$7,585.78
Median
$7,585.78
Typical High
$7,585.78
Providence
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$79.43
Typical High
$79.43