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Utah 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
$870.96 / $870.96 / $870.96
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$870.96 / $1,621.81 / $15,488.17
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,290.87 / $2,290.87 / $2,290.87
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,659.59 / $1,659.59 / $2,454.71
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.26 / $1,949.84 / $2,511.89
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,995.26 / $2,344.23 / $4,073.80
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,479.11 / $1,905.46 / $2,884.03
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,398.83 / $2,691.53 / $3,467.37
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,949.84 / $2,754.23 / $4,073.80
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,122.02 / $1,778.28 / $1,995.26
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,047.13 / $1,348.96 / $1,995.26