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Missouri rates for HCPCS L8415

Prosthetic sheath, upper limb, each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13.34 / $19.73 / $20.36
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.73 / $15.28 / $27.79
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$29.19 / $30.65 / $134.74
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.59 / $15.65 / $23.62
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.30 / $16.30 / $16.30
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.91 / $11.91 / $17.39
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13.34 / $23.52 / $134.22
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.70 / $15.60 / $27.33
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.70 / $14.57 / $20.68