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Illinois rates for HCPCS L6920

Wrist disarticulation, external power, self-suspended inner socket, removable forearm shell, Otto Bock or equal switch, cables, two batteries and one charger, switch control of terminal device

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,011.87 / $5,011.87 / $10,232.93
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,467.37 / $5,011.87 / $9,549.93
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12,022.64 / $19,498.45 / $69,183.10
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,606.93 / $6,606.93 / $10,000.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,786.30 / $4,786.30 / $10,232.93
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7,413.10 / $9,332.54 / $11,748.98
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
$13,182.57 / $13,182.57 / $13,182.57
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,248.07 / $8,128.31 / $13,182.57
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,548.13 / $5,011.87 / $7,585.78