go back

Indiana rates for HCPCS L6677

Upper extremity addition, harness, triple control, simultaneous operation of terminal device and elbow

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$170.43 / $170.43 / $358.10
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$170.43 / $174.86 / $178.23
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$282.89 / $320.50 / $358.10
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$179.41 / $195.45 / $263.85
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$270.08 / $393.91 / $537.15
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$304.39 / $393.91 / $483.44
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$231.66 / $231.66 / $358.10
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$169.11 / $231.66 / $367.35
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$106.40 / $178.65 / $245.94