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North Carolina 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
$1,188.32 / $1,257.97 / $2,411.67
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$714.24 / $1,188.32 / $1,188.32
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,280.07 / $1,536.09 / $2,916.61
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,111.54 / $1,197.44 / $1,197.44
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 / $886.63 / $1,840.88
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$457.00 / $1,188.32 / $1,780.26
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,168.29 / $1,168.29 / $1,168.29
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,859.90 / $1,859.90 / $2,859.60
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$611.96 / $796.51 / $1,249.59
Wellcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,667.81 / $7,396.37 / $7,396.37
Wellcare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8,010.83 / $11,624.25 / $11,624.25