go back

Idaho 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
$1,318.26 / $1,778.28 / $2,511.89
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,089.30 / $2,818.38 / $4,365.16
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,162.28 / $3,311.31 / $3,311.31
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,862.09 / $1,949.84 / $1,949.84
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,412.54 / $1,412.54 / $1,949.84
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,096.48 / $2,818.38 / $3,090.30
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,454.71 / $2,884.03 / $3,019.95
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.20 / $30.20 / $30.20
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,818.38 / $2,884.03 / $2,884.03
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,089.30 / $2,187.76 / $3,311.31
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,344.23 / $3,019.95 / $3,090.30
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,778.28 / $1,995.26 / $2,041.74
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,230.27 / $1,348.96 / $2,041.74