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Oklahoma 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
$1,644.01 / $1,644.01 / $1,644.01
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,644.01 / $1,878.87 / $1,896.63
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 / $2,381.07
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,633.08 / $2,494.36 / $17,752.32
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,132.68 / $1,872.89 / $3,878.84
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,132.68 / $1,826.35 / $2,618.15