go back

Wisconsin 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
$1,655.22 / $1,655.22 / $1,655.22
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,177.60 / $1,655.22 / $2,748.28
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,281.15 / $3,609.27 / $5,971.69
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,585.56 / $3,051.47 / $4,035.81
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,360.44 / $7,021.66 / $7,021.66
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,283.76 / $7,244.26 / $13,696.13
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,667.14 / $4,831.08 / $6,209.84
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$863.01 / $2,482.83 / $3,773.32
DeanCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,878.71 / $3,281.15 / $3,937.38
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,493.91 / $3,281.15 / $14,087.74
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,478.00 / $2,013.70 / $3,572.77
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.00 / $65.00 / $85.00
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$863.01 / $2,482.83 / $3,773.32
Prevea360
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,878.71 / $3,281.15 / $3,937.38
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,281.15 / $5,049.56 / $8,021.57
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,283.76 / $6,408.50 / $14,087.74
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,667.14 / $2,283.76 / $18,640.13
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,281.15 / $3,281.15 / $3,281.15
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,281.15 / $3,281.15 / $3,281.15
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,114.00 / $1,968.69 / $2,909.12