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Utah rates for HCPCS L6882

Microprocessor Control Feature Addition To Upper Limb Prosthetic Terminal Device (Special Coverage Instructions Apply. See Mcm: 2133)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,077.14 / $1,077.14 / $1,077.14
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,077.14 / $1,183.83 / $10,542.60
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,264.80 / $2,264.80 / $2,264.80
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,653.30 / $2,264.80 / $2,414.39
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,713.06 / $2,763.01 / $3,591.91
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,314.11 / $3,696.10 / $3,696.10
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,104.69 / $2,649.37 / $3,974.05
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,506.48 / $1,668.47 / $2,387.65