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Montana 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
$2,972.00 / $10,308.20 / $10,308.20
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,283.76 / $2,813.54 / $2,813.54
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,283.76 / $2,813.54 / $2,813.54
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,493.91 / $2,679.56 / $2,813.54
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,111.67 / $2,283.76 / $3,123.05
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,208.22 / $1,336.80 / $2,120.16