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Indiana 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
$4,786.30 / $4,786.30 / $4,786.30
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,801.89 / $4,786.30 / $6,760.83
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,897.79 / $10,232.93 / $12,882.50
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,786.30 / $4,897.79 / $8,709.64
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,943.28 / $10,000.00 / $12,022.64
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,888.44 / $6,606.93 / $10,232.93
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,786.30 / $4,786.30 / $8,912.51
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,248.07 / $6,165.95 / $8,128.31
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,691.53 / $5,011.87 / $6,760.83