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Oklahoma 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
$3,773.80 / $3,773.80 / $3,773.80
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,773.80 / $4,312.92 / $4,312.92
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,541.83 / $6,541.83 / $6,541.83
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,775.54 / $6,541.83 / $6,541.83
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,579.84 / $5,282.61 / $42,519.53
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,664.10 / $5,280.66 / $8,903.85
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,078.09 / $9,078.09 / $9,078.09
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,664.10 / $3,996.14 / $6,020.97