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Maine 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
$1,177.55 / $1,815.14 / $1,815.14
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,397.00 / $3,105.54 / $5,756.69
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,487.71 / $1,574.14 / $2,023.34
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
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,182.08 / $2,182.08 / $2,182.08
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,517.51 / $1,815.14 / $1,815.14
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$948.17 / $1,854.16 / $3,092.04