go back

Michigan rates for HCPCS L6623

Upper Extremity Addition Spring Assisted Rotational Wrist Unit With Latch Release

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$491.88 / $491.88 / $491.88
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$411.48 / $491.88 / $491.88
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,303.63 / $2,597.34 / $4,730.60
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$818.23 / $861.30 / $1,162.76
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$559.85 / $575.37 / $667.26
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$689.04 / $689.04 / $689.04
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$496.34 / $496.34 / $496.34
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$362.33 / $716.16 / $1,248.28
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$491.88 / $622.41 / $622.41
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$491.88 / $622.41 / $968.75
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$541.75 / $637.36 / $732.96
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$327.92 / $408.89 / $616.46