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Arizona 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
$1,325.95 / $1,357.84 / $2,259.12
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$773.58 / $2,794.54 / $5,052.42
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,933.94 / $2,578.59 / $3,513.33
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,952.91 / $1,952.91 / $1,952.91
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,425.62 / $1,425.62 / $3,499.88
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$868.59 / $1,968.81 / $14,058.21
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,216.04 / $1,345.45 / $2,073.29
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,216.04 / $1,345.45 / $2,026.73