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Idaho 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
$1,949.50 / $2,825.30 / $2,972.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,240.87 / $2,283.76 / $2,283.76
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,667.14 / $1,667.14 / $2,434.60
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$863.01 / $2,367.50 / $3,361.01
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,024.91 / $3,192.96 / $3,361.01
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $2,480.42 / $2,954.02
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,943.02 / $3,282.24 / $4,923.35
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,352.71 / $2,352.71 / $3,529.06
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,235.98 / $1,336.80 / $2,245.71