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Hawaii 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
$1,026.29 / $1,026.29 / $1,026.29
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,636.40 / $3,636.40 / $3,636.40
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,283.76 / $2,283.76 / $5,035.21
HMSA
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,577.46 / $4,793.14 / $4,793.14
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,746.48 / $4,577.46 / $6,408.44
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,045.66 / $3,636.40 / $5,035.21
University Health Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,687.32 / $3,813.69 / $4,356.89