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Hawaii rates for HCPCS L6026

Transcarpal/metacarpal or partial hand disarticulation prosthesis, external power, self-suspended, inner socket with removable forearm section, electrodes and cables, two batteries, charger, myoelectric control of terminal device, excludes terminal device(s)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,835.28 / $1,835.28 / $1,835.28
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,145.50 / $4,145.50 / $4,145.50
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,323.97 / $4,541.81 / $5,740.15
HMSA
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,231.52 / $1,231.52 / $1,231.52
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,652.82 / $5,218.32 / $7,305.65
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,545.90 / $4,879.13 / $5,740.15
University Health Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,203.56 / $4,347.62 / $4,966.88