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Oregon 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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,850.00 / $6,850.00 / $6,850.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,133.39 / $5,133.39 / $6,850.00
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,133.39 / $5,133.39 / $7,032.76
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$79,999.20 / $79,999.20 / $79,999.20
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,133.39 / $5,390.07 / $2,700,000.00
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,250,000.00 / $2,250,000.00 / $2,400,000.00