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Utah rates for HCPCS L6687

Upper Extremity Addition Frame Type Socket Below Elbow Or Wrist Disarticulation

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$222.98 / $222.98 / $222.98
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$222.98 / $226.86 / $2,020.34
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$432.60 / $432.60 / $432.60
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$315.80 / $432.60 / $532.23
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$417.80 / $673.88 / $876.04
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$808.29 / $901.45 / $901.45
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$513.32 / $646.16 / $969.24
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$287.83 / $456.41 / $460.52
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$311.86 / $345.39 / $495.50