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Alaska rates for HCPCS L6638

Upper extremity addition to prosthesis, electric locking feature, only for use with manually powered elbow

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,621.81 / $1,778.28 / $2,570.40
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,949.84 / $1,949.84 / $1,949.84
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,412.54 / $1,412.54 / $2,089.30
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$870.96 / $2,570.40 / $2,884.03
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,187.76 / $3,019.95 / $9,772.37
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,570.40 / $2,884.03 / $3,019.95
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,344.23 / $2,884.03 / $2,951.21
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$870.96 / $870.96 / $3,019.95
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.26 / $1,949.84 / $2,818.38
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,778.28 / $1,778.28 / $2,041.74
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,479.11 / $1,479.11 / $6,456.54