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Montana rates for HCPCS L6883

Replacement socket, below elbow/wrist disarticulation, molded to patient model, for use with or without external power

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,716.30 / $5,952.89 / $5,952.89
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,551.30 / $2,159.89 / $2,159.89
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,551.30 / $2,159.89 / $2,159.89
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,061.88 / $2,057.04 / $2,159.89
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,551.30 / $1,621.09 / $2,341.06
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$858.81 / $950.20 / $1,464.24