go back

Arizona rates for HCPCS L6621

Upper extremity prosthesis addition, flexion/extension wrist with or without friction, for use with external powered terminal device

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,174.90 / $1,380.38 / $5,370.32
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$707.95 / $1,621.81 / $3,388.44
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,041.74 / $2,691.53 / $5,128.61
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,778.28 / $1,778.28 / $1,778.28
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,318.26 / $1,318.26 / $1,778.28
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$794.33 / $1,737.80 / $5,623.41
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,122.02 / $1,230.27 / $13,803.84
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$954.99 / $1,905.46 / $2,137.96
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,122.02 / $1,230.27 / $1,862.09