go back

West Virginia 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
$344.57 / $344.57 / $344.57
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$344.57 / $344.57 / $383.49
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$462.26 / $948.63 / $1,229.71
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$456.75 / $497.82 / $853.40
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$564.36 / $564.36 / $857.79
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$411.98 / $564.36 / $3,595.24
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$350.56 / $440.60 / $584.27