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Missouri 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
Facility
Modifier
Low / Median / High Price
$1,255.35 / $1,856.89 / $1,916.36
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,255.35 / $1,438.44 / $2,615.34
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,747.74 / $2,885.13 / $12,683.57
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,373.05 / $1,487.71 / $2,224.09
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 / $1,839.83
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,255.35 / $2,301.50 / $12,858.35
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,025.52 / $1,468.77 / $2,220.77
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,025.52 / $1,370.82 / $1,945.81