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North Dakota rates for HCPCS L6629

Upper extremity addition, quick disconnect lamination collar with coupling piece, Otto Bock or equal

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$158.49 / $158.49 / $194.98
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.43 / $104.71 / $194.98
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$181.97 / $245.47 / $269.15
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$269.15 / $269.15 / $338.84
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$93.33 / $194.98 / $912.01
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.43 / $109.65 / $208.93
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$114.82 / $288.40 / $288.40
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$69.18 / $131.83 / $251.19