go back

Montana rates for HCPCS K0891

Power wheelchair, group 5 pediatric, multiple power option, sling/solid seat/back, patient weight capacity up to and including 125 pounds

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13,489.63 / $13,489.63 / $22,387.21
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11,748.98 / $11,748.98 / $11,748.98
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11,748.98 / $11,748.98 / $14,791.08
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11,748.98 / $11,748.98 / $11,748.98
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.43 / $79.43 / $11,748.98