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South Carolina 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
$3,548.13 / $3,548.13 / $3,548.13
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,388.44 / $4,897.79 / $6,165.95
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,677.35 / $8,128.31 / $9,549.93
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,548.13 / $6,606.93 / $14,454.40
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,786.30 / $4,786.30 / $10,964.78
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,365.16 / $5,623.41 / $6,165.95
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,548.13 / $6,456.54 / $14,125.38
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,570.40 / $2,570.40 / $2,630.27
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.20 / $30.20 / $30.20
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,801.89 / $6,025.60 / $10,964.78
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,162.28 / $3,981.07 / $6,025.60