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Illinois 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
Facility
Modifier
Low / Median / High Price
$1,623.99 / $1,623.99 / $1,623.99
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,196.61 / $1,623.99 / $2,492.73
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,920.94 / $6,633.54 / $28,231.76
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,493.67 / $2,493.67 / $2,493.67
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,283.76 / $2,283.76 / $3,513.21
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,667.14 / $2,261.52 / $3,804.00
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,731.70 / $3,193.83 / $3,836.67
Hally Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,265.50 / $4,265.50 / $4,265.50
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,114.00 / $1,636.93 / $2,858.19