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Montana rates for HCPCS L6055

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,232.85 / $11,213.00 / $11,213.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,476.09 / $3,566.82 / $3,566.82
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,476.09 / $2,900.56 / $3,566.82
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,771.66 / $3,396.97 / $3,566.82
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,476.09 / $2,677.05 / $3,703.44
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,432.85 / $1,585.34 / $2,514.34