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New Jersey 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
$3,398.34 / $3,398.34 / $3,398.34
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,398.34 / $4,529.42 / $6,322.56
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,348.22 / $7,261.93 / $9,247.54
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,301.21 / $5,301.21 / $12,525.00
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8,448.29 / $8,507.74 / $12,114.28
Horizon BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9,030.79 / $9,247.54 / $9,247.54
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,265.55 / $4,969.14 / $9,247.54