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Massachusetts rates for HCPCS L6580

Preparatory, wrist disarticulation or below elbow, single wall plastic socket, friction wrist, flexible elbow hinges, figure of eight harness, humeral cuff, Bowden cable control, USMC or equal pylon, no cover, molded to patient model

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$850.65 / $850.65 / $850.65
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$850.65 / $897.22 / $1,575.69
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,118.70 / $3,528.38 / $10,188.70
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$936.00 / $1,442.35 / $1,901.24
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,066.40 / $2,514.02 / $3,237.58
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,274.83 / $1,727.41 / $1,727.41
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,125.11 / $1,430.93 / $1,576.65
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,150.95 / $1,576.65 / $2,825.63
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$83.43 / $4,618.00 / $9,239.00
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,576.30 / $1,576.30 / $1,655.12
Health New England
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,274.21 / $1,274.21 / $1,274.21
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,947.70 / $10,188.70 / $10,188.70
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$780.00 / $1,040.68 / $1,901.24
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$804.70 / $1,040.68 / $1,880.80