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Maine rates for HCPCS L6687

Upper extremity addition, frame type socket, below elbow or wrist disarticulation

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$302.49 / $466.28 / $466.28
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$615.74 / $797.75 / $1,478.77
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$420.80 / $441.80 / $519.76
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$432.60 / $432.60 / $508.84
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$315.80 / $315.80 / $432.60
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$560.54 / $560.54 / $560.54
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$389.82 / $466.28 / $466.28
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$456.41 / $456.41 / $456.41
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$230.26 / $345.39 / $794.28