go back

Texas 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

Facilitymedian $5,129 · 10th–90th $100–$7,5860%50%10th90th$5,129Professionalmedian $5,129 · 10th–90th $5,129–$5,1290%50%$5,129$50.0$200.0$1.0K$5.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5,128.61 / $5,128.61 / $5,128.61
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$16,595.87 / $16,595.87 / $16,595.87
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5,623.41 / $7,079.46 / $16,595.87
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,128.61 / $5,128.61 / $6,918.31
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5,128.61 / $5,128.61 / $5,128.61
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $275.42 / $323.59
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,128.61 / $5,128.61 / $7,585.78
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5,128.61 / $5,128.61 / $16,595.87
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$338.84 / $338.84 / $398.11
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5,248.07 / $5,248.07 / $5,248.07