go back

Utah rates for HCPCS L6675

Upper Extremity Addition Harness (E.G. Figure Of Eight Type) Single Cable Design. (Rvsd 1/1/04)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$46.42 / $46.42 / $46.42
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$46.42 / $59.36 / $528.62
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$90.07 / $90.07 / $90.07
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$65.75 / $90.07 / $96.02
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$65.24 / $105.23 / $136.79
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$126.22 / $140.76 / $140.76
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$80.16 / $100.90 / $151.35
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.93 / $71.91 / $100.45