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Michigan rates for HCPCS L6055

Wrist disarticulation, molded socket with expandable interface, flexible elbow hinges, triceps pad

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,185.96 / $2,185.96 / $2,185.96
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,821.64 / $2,185.96 / $2,185.96
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,793.49 / $11,542.87 / $21,023.37
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,636.33 / $3,827.72 / $5,167.42
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,065.53 / $2,355.69 / $2,488.02
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,062.18 / $3,062.18 / $3,062.18
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,476.09 / $2,476.09 / $2,476.09
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,476.09 / $2,476.09 / $4,437.38
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,185.96 / $2,766.07 / $2,766.07
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,185.96 / $2,766.07 / $4,305.20
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,322.65 / $2,832.51 / $3,257.38
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,321.12 / $1,829.89 / $2,557.56