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Maryland rates for HCPCS L6975

Interscapular-Thoracic 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
Professional
Modifier
Low / Median / High Price
$8,734.09 / $10,406.58 / $16,967.90
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11,149.90 / $11,149.90 / $14,507.58
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13,847.37 / $13,847.37 / $13,847.37
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10,108.58 / $10,108.58 / $13,847.37
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14,855.76 / $21,222.51 / $30,560.41
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9,568.90 / $10,951.89 / $16,789.18
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11,606.23 / $11,606.23 / $14,855.76