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Massachusetts 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
$3,981.07 / $3,981.07 / $3,981.07
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,467.37 / $4,786.30 / $8,511.38
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,128.31 / $9,332.54 / $42,657.95
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,981.07 / $6,606.93 / $9,332.54
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,772.37 / $12,022.64 / $15,848.93
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6,025.60 / $8,128.31 / $8,128.31
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,248.07 / $6,606.93 / $6,606.93
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,786.30 / $4,786.30 / $6,606.93
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$83.18 / $4,897.79 / $9,772.37
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7,943.28 / $7,943.28 / $12,302.69
Health New England
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,128.61 / $5,128.61 / $5,128.61
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,128.31 / $9,332.54 / $42,657.95
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,981.07 / $6,918.31 / $10,232.93
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.31 / $6,025.60 / $10,964.78
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,801.89 / $6,025.60 / $7,943.28