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Maine 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
$1,287.43 / $1,984.51 / $1,984.51
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,620.67 / $3,395.32 / $6,293.85
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,647.60 / $1,721.00 / $2,212.15
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,952.91 / $1,952.91 / $2,165.69
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,425.62 / $1,425.62 / $1,952.91
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,385.69 / $2,385.69 / $2,385.69
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,659.11 / $1,984.51 / $1,984.51
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$980.00 / $1,514.26 / $3,380.56