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Idaho 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
$6,212.15 / $8,586.04 / $8,586.04
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,405.64 / $7,261.93 / $7,261.93
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,301.21 / $5,301.21 / $11,026.65
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,978.39 / $7,668.27 / $10,214.07
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9,192.66 / $9,703.37 / $10,214.07
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $30.00 / $30.00
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,943.79 / $9,974.68 / $14,962.02
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7,149.85 / $7,351.10 / $10,724.77
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,265.55 / $4,613.50 / $12,790.85