go back

South Dakota 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
$9,049.23 / $9,049.23 / $9,049.23
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7,738.06 / $9,049.23 / $10,255.44
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,261.93 / $7,261.93 / $10,905.82
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12,525.00 / $12,650.25 / $15,656.25
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,871.76 / $15,293.20 / $48,028.87
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,183.68 / $6,985.50 / $11,333.34
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,067.98 / $10,905.82 / $17,746.28
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8,951.70 / $11,059.31 / $20,840.78
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8,759.70 / $10,255.44 / $12,190.22
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,612.32 / $6,151.33 / $8,731.87
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9,716.09 / $9,716.09 / $9,716.09