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Maryland 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
$1,156.49 / $1,321.54 / $2,154.78
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,445.10 / $1,510.34 / $1,842.34
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,786.24 / $1,786.24 / $1,786.24
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,303.96 / $1,303.96 / $1,786.24
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,886.56 / $2,695.08 / $3,880.92
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,214.00 / $1,385.01 / $2,132.08
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,492.65 / $1,492.65 / $1,886.56