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Montana rates for HCPCS L6647

Upper Extremity Addition Shoulder Lock Mechanism Body Powered Actuator

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$508.92 / $1,765.15 / $1,765.15
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$405.51 / $665.45 / $665.45
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$405.51 / $541.16 / $665.45
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$312.20 / $633.76 / $665.45
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$405.51 / $499.46 / $665.94
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$252.49 / $279.36 / $430.49