go back

Power Wheelchair, Group 4 Standard, Single Power Option

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

Rates data updated October 2026.

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

$324

Typical negotiated rate. In Texas, October 2026.

Insurers have agreed to pay about $324 for this service. The price depends on where it is billed: about $275 from a physician practice, and about $5,129 from a hospital or other facility.

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 6 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$275$214 to $324
FacilityA hospital or hospital-owned outpatient department$5,129$5,129 to $5,129

How much rates vary

Facilitymedian $5,129 · 10th to 90th $5,129 to $7,413Professionalmedian $275 · 10th to 90th $30 to $5,129
$50$200$1K$5Kfacility $5,129professional $275

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

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$5,128.61
Median
$5,128.61
Typical High
$5,128.61
Aetna
Setting
Professional
Modifier
None
Typical Low
$5,128.61
Median
$5,128.61
Typical High
$5,128.61
Aetna
Setting
Professional
Modifier
UE · Used equipment
Typical Low
$4,073.80
Median
$4,073.80
Typical High
$4,073.80
Cigna
Setting
Facility
Modifier
None
Typical Low
$16,595.87
Median
$16,595.87
Typical High
$16,595.87
Cigna
Setting
Professional
Modifier
None
Typical Low
$5,623.41
Median
$7,079.46
Typical High
$16,595.87
Moda Health
Setting
Facility
Modifier
None
Typical Low
$5,128.61
Median
$5,128.61
Typical High
$7,413.10
Moda Health
Setting
Professional
Modifier
None
Typical Low
$5,128.61
Median
$5,128.61
Typical High
$5,128.61
Moda Health
Setting
Professional
Modifier
UE · Used equipment
Typical Low
$4,073.80
Median
$4,073.80
Typical High
$4,073.80
Molina
Setting
Professional
Modifier
None
Typical Low
$30.20
Median
$275.42
Typical High
$323.59
Providence
Setting
Facility
Modifier
None
Typical Low
$5,128.61
Median
$5,128.61
Typical High
$7,413.10
Providence
Setting
Professional
Modifier
None
Typical Low
$5,128.61
Median
$15,488.17
Typical High
$16,595.87
Wellpoint
Setting
Professional
Modifier
None
Typical Low
$5,248.07
Median
$5,248.07
Typical High
$5,623.41

Where Texas 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.

Texas· 48th of 50

$324

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.