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Power Wheelchair, Group 4 Standard, Single Power Option

Wisconsin 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 does Power Wheelchair, Group 4 Standard, Single Power Option cost?

$5,129

Typical negotiated rate. In Wisconsin, July 2026.

Insurers have agreed to pay about $5,129 for this service. The price depends on where it is billed: about $5,129 from a physician practice, and about $5,129 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

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 9 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$5,129$5,129 to $5,129
FacilityA hospital or hospital-owned outpatient department$5,129$5,129 to $8,318

How much rates vary

Facilitymedian $5,129 · 10th to 90th $79 to $13,490Professionalmedian $5,129 · 10th to 90th $5,129 to $5,248
$100$500$2K$10Kfacility $5,129professional $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. 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
Global
Typical Low
$5,128.61
Median
$5,128.61
Typical High
$5,128.61
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
$3,548.13
Median
$5,248.07
Typical High
$5,248.07
Cigna
Setting
Facility
Modifier
Global
Typical Low
$13,489.63
Median
$15,488.17
Typical High
$25,118.86
Cigna
Setting
Professional
Modifier
Global
Typical Low
$5,623.41
Median
$5,754.40
Typical High
$7,079.46
DeanCare
Setting
Facility
Modifier
Global
Typical Low
$5,128.61
Median
$5,128.61
Typical High
$9,332.54
Medica
Setting
Facility
Modifier
Global
Typical Low
$79.43
Median
$5,128.61
Typical High
$8,317.64
Medica
Setting
Professional
Modifier
Global
Typical Low
$263.03
Median
$263.03
Typical High
$263.03
Molina
Setting
Professional
Modifier
Global
Typical Low
$50.12
Median
$58.88
Typical High
$2,754.23
Prevea360
Setting
Facility
Modifier
Global
Typical Low
$5,128.61
Median
$5,128.61
Typical High
$9,332.54
Quartz
Setting
Facility
Modifier
Global
Typical Low
$64.57
Median
$64.57
Typical High
$100.00
United
Setting
Professional
Modifier
Global
Typical Low
$398.11
Median
$398.11
Typical High
$398.11

Where Wisconsin sits

The same service costs 1.7 times more in Wyoming than in Minnesota. 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.

Wisconsin· 31st of 50

$5,129

WY $6,918MN $4,169

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.