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Massachusetts 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
Facility
Modifier
Low / Median / High Price
$4,650.14 / $4,650.14 / $4,650.14
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,650.14 / $4,823.79 / $7,738.06
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,898.60 / $18,604.18 / $48,511.09
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,622.32 / $7,316.97 / $10,393.40
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11,296.28 / $13,743.22 / $17,698.66
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6,969.03 / $9,443.16 / $9,443.16
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,156.05 / $7,261.93 / $7,461.22
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,301.21 / $5,301.21 / $12,525.00
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$83.43 / $4,618.00 / $9,239.00
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8,617.03 / $8,617.03 / $9,047.87
Health New England
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6,850.74 / $6,850.74 / $6,850.74
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$21,931.69 / $48,511.09 / $48,511.09
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,157.35 / $5,689.01 / $10,393.40
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,613.50 / $6,078.01 / $9,247.54