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Maryland rates for HCPCS L6697

Addition To Upper Extremity Prosthesis Below Elbow/Above Elbow Custom

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$665.09 / $760.00 / $1,239.18
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$905.55 / $905.55 / $1,059.50
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,111.22 / $1,111.22 / $1,111.22
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$811.19 / $811.19 / $811.19
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,084.93 / $1,549.90 / $2,231.86
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$698.15 / $799.82 / $1,226.11
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$858.60 / $858.60 / $1,084.93