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Georgia rates for HCPCS L6696

Addition To Upper Extremity Prosthesis Below Elbow/Above Elbow Custom

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$665.09 / $665.09 / $1,911.66
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$665.09 / $852.21 / $1,064.14
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,596.58 / $2,235.21 / $5,859.45
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$906.37 / $1,327.52 / $2,548.84
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,317.42 / $1,357.09 / $2,953.67
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,357.09 / $1,357.09 / $1,357.09
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$886.63 / $886.63 / $886.63
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$647.24 / $647.24 / $1,840.88
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,213.40 / $1,596.58 / $3,373.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$554.27 / $796.51 / $1,314.11