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Power Wheelchair, Group 4 Standard, Single Power Option

New Hampshire 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

Professionalmedian $5,129 · 10th to 90th $5,129 to $5,248
$5Kprofessional $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
Professional
Modifier
Global
Typical Low
$5,128.61
Median
$5,128.61
Typical High
$5,128.61
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$5,248.07
Median
$5,248.07
Typical High
$5,248.07