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Utah rates for HCPCS L6584

Preparatory Elbow Disarticulation Or Above Elbow Single Wall Plastic Socket Friction Wrist Locking Elbow Figure Of Eight Harness Fair Lead Cable Control Usmc Or Equal Pylon No Cover Molded To Patient Model

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$791.23 / $791.23 / $791.23
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$791.23 / $868.88 / $7,737.79
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,960.76 / $1,960.76 / $1,960.76
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,431.35 / $1,960.76 / $2,090.26
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,111.92 / $1,793.43 / $2,331.45
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,151.15 / $2,399.09 / $2,399.09
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,366.12 / $1,719.67 / $2,579.50
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,106.60 / $1,225.59 / $1,753.89