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Illinois 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
$1,886.41 / $1,886.41 / $1,886.41
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,661.24 / $1,886.41 / $3,127.04
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,031.00 / $18,352.24 / $40,028.56
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,381.07 / $2,381.07 / $4,171.89
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,738.18 / $2,381.07 / $4,418.63
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,049.10 / $3,535.31 / $4,295.50
Hally Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,954.78 / $4,954.78 / $4,954.78
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,415.86 / $1,901.45 / $3,264.15