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Utah rates for HCPCS L6050

Wrist disarticulation, molded socket, flexible elbow hinges, triceps pad

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$741.31 / $741.31 / $741.31
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$741.31 / $1,348.96 / $13,182.57
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,412.54 / $1,412.54 / $1,412.54
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,047.13 / $1,047.13 / $1,479.11
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.26 / $1,778.28 / $2,344.23
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,819.70 / $2,137.96 / $3,715.35
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,348.96 / $1,737.80 / $2,630.27
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,187.76 / $2,454.71 / $2,630.27
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,737.80 / $2,511.89 / $3,162.28
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$954.99 / $1,513.56 / $1,698.24
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$891.25 / $1,148.15 / $1,698.24