go back

Alaska rates for HCPCS L6925

Wrist disarticulation, external power, self-suspended inner socket, removable forearm shell, Otto Bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9,032.28 / $9,032.28 / $9,032.28
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,261.93 / $7,261.93 / $7,261.93
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,301.21 / $5,301.21 / $5,301.21
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,978.39 / $2,978.39 / $2,978.39
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9,703.37 / $9,798.96 / $15,472.07
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,978.39 / $2,978.39 / $7,261.93
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,301.21 / $7,575.35 / $11,969.62
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,985.33 / $5,145.89 / $9,862.95