go back

South Dakota 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
$13,531.66 / $13,531.66 / $16,247.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11,619.91 / $11,619.91 / $11,619.91
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$27,457.43 / $27,457.43 / $44,516.78