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Nebraska 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
$5,754.40 / $5,754.40 / $5,754.40
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,677.35 / $5,754.40 / $38,904.51
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7,943.28 / $8,709.64 / $8,709.64
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
$6,606.93 / $11,748.98 / $15,488.17
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,754.40 / $9,772.37 / $42,657.95
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,019.95 / $5,370.32 / $8,912.51
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9,772.37 / $10,000.00 / $22,387.21
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10,000.00 / $10,000.00 / $10,000.00
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12,589.25 / $22,387.21 / $22,387.21
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,801.89 / $6,025.60 / $9,332.54
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,311.31 / $4,466.84 / $6,760.83