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Idaho 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
$2,262.46 / $3,127.04 / $3,127.04
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 / $3,094.31 / $3,719.97
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,347.97 / $3,533.97 / $3,719.97
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $30.00 / $30.00
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,257.33 / $3,632.78 / $5,449.17
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,603.98 / $2,702.60 / $3,905.97
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,570.89 / $1,699.03 / $4,658.43