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West Virginia 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
$1,824.10 / $1,824.10 / $1,824.10
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,808.02 / $1,824.10 / $1,961.91
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,490.80 / $5,021.96 / $6,509.95
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,417.98 / $2,682.40 / $4,598.39
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,381.07 / $2,381.07 / $4,490.63
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,738.18 / $2,381.07 / $18,283.37
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,855.85 / $2,559.92 / $3,093.08