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Alaska rates for HCPCS L6884

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,714.30 / $3,714.30 / $3,714.30
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,283.76 / $2,283.76 / $2,283.76
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,667.14 / $2,283.76 / $2,434.60
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$863.01 / $863.01 / $863.01
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,192.96 / $4,029.58 / $6,362.49
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$863.01 / $863.01 / $2,283.76
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,667.14 / $2,434.60 / $3,938.69
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,116.12 / $2,116.12 / $4,055.90