go back

Georgia 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
Facility
Modifier
Low / Median / High Price
$1,596.31 / $1,596.31 / $18,352.71
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,596.31 / $2,176.63 / $2,605.86
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,832.00 / $5,364.80 / $14,063.44
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,716.41 / $3,395.51 / $6,265.27
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,161.97 / $3,257.20 / $7,089.20
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,257.20 / $3,257.20 / $3,257.20
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 / $4,418.63
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,912.32 / $3,832.00 / $5,911.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,274.50 / $1,914.86 / $3,387.83