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New Mexico 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
$5,123.32 / $5,123.32 / $5,123.32
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,123.32 / $6,993.74 / $29,466.60
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 / $13,276.50
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7,429.81 / $9,287.27 / $13,930.90
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 / $7,261.93 / $11,969.62
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,265.55 / $5,145.89 / $7,059.89