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Power Wheelchair, Group 4 Standard, Single Power Option

Nebraska 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 October 2026.

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

$6,918

Typical negotiated rate. In Nebraska, October 2026.

Insurers have agreed to pay about $6,918 for this service. Most negotiated rates run $5,129 to $6,918.

Few insurers publish rates for this combination, so treat this figure as a rough guide.

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 4 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $5,129 · 10th to 90th $5,129 to $9,772Professionalmedian $6,918 · 10th to 90th $5,129 to $12,303
$100$200$500$1K$2K$5K$10Kfacility $5,129professional $6,918

Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$6,918.31
Median
$6,918.31
Typical High
$6,918.31
Aetna
Setting
Professional
Modifier
None
Typical Low
$5,128.61
Median
$6,918.31
Typical High
$12,302.69
Cigna
Setting
Professional
Modifier
None
Typical Low
$5,623.41
Median
$5,623.41
Typical High
$7,079.46
Medica
Setting
Facility
Modifier
None
Typical Low
$5,128.61
Median
$5,128.61
Typical High
$9,772.37
Medica
Setting
Professional
Modifier
None
Typical Low
$309.03
Median
$309.03
Typical High
$5,128.61
1 more rate with less common billing modifiers

A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.

Insurance Carrier
United
Setting
Professional
Modifier
RR · Rental
Typical Low
$309.03
Median
$309.03
Typical High
$309.03

Where Nebraska sits

The same service costs 234422.9 times more in South Dakota than in Louisiana. 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.

Nebraska· 4th of 50

$6,918

SD $7,079LA $0.03

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.