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Alaska rates for HCPCS L6715

Terminal Device Multiple Articulating Digit Includes Motor(S) Initial Issue Or Replacement (Reinstated Code Previous Description Was Terminal Device Hook Dorrance Or Equal Model # 5xa (Special Coverage Instructions Apply. See Mcm: 2133)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,257.46 / $3,257.46 / $3,257.46
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,381.07 / $2,381.07 / $2,381.07
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,738.18 / $2,381.07 / $2,452.50
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,494.36 / $2,494.36 / $2,494.36
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,533.97 / $3,533.97 / $5,579.96
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,257.33 / $3,257.33 / $3,632.78
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,943.37 / $3,632.78 / $7,491.43
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,494.36 / $2,494.36 / $2,494.36
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,381.07 / $2,955.19 / $4,359.34
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,797.94 / $1,855.85 / $3,557.04