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Minnesota rates for HCPCS L6638

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,528.64 / $2,528.64 / $2,528.64
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,393.66 / $2,374.89 / $2,528.64
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,586.11 / $3,018.93 / $4,203.76
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,415.14 / $2,867.98 / $3,018.93
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,952.91 / $9,315.09 / $25,871.87
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,499.88 / $3,709.87 / $4,444.84
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,530.26 / $8,937.37 / $20,371.55
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,499.88 / $3,499.88 / $3,601.60
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$894.65 / $3,018.93 / $14,058.21
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$896.96 / $1,504.66 / $3,031.54
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$896.96 / $1,502.41 / $3,031.54