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North Carolina rates for HCPCS L6965

Shoulder disarticulation, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, 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
$12,890.01 / $12,890.01 / $26,160.10
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7,987.08 / $12,890.01 / $12,890.01
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15,777.02 / $25,689.54 / $31,637.37
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12,057.17 / $12,988.90 / $12,988.91
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10,712.86 / $11,736.82 / $11,736.82
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8,567.87 / $11,736.82 / $21,033.75
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,478.66 / $12,890.01 / $20,370.45
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9,738.00 / $9,738.00 / $12,151.00
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20,409.50 / $20,409.50 / $31,385.40
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6,638.14 / $8,676.65 / $14,400.05
Wellcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$32,206.69 / $87,176.00 / $87,176.00
Wellcare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$112,269.81 / $112,269.81 / $127,579.28