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North Dakota rates for HCPCS L6695

Addition To Upper Extremity Prosthesis Below Elbow/Above Elbow Custom

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$551.33 / $551.33 / $551.33
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$551.33 / $662.27 / $662.27
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$708.53 / $837.74 / $858.58
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$916.50 / $925.67 / $1,163.96
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$221.71 / $551.33 / $3,490.81
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$301.89 / $500.13 / $612.85
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$261.07 / $500.13 / $790.68