go back

Maine 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
$4,650.14 / $7,167.96 / $7,167.96
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,465.74 / $12,263.74 / $22,733.11
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,623.53 / $5,901.24 / $7,990.17
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,261.93 / $7,261.93 / $7,822.39
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,301.21 / $5,301.21 / $7,261.93
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8,617.03 / $8,617.03 / $8,617.03
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,992.63 / $7,167.96 / $7,167.96
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,554.63 / $6,951.12 / $12,210.44