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Texas rates for HCPCS L8415

Prosthetic Sheath Upper Limb Each (Special Coverage Instructions Apply. See Mcm: 2133)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12.30 / $12.30 / $13.28
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.25 / $13.28 / $24.59
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.72 / $16.72 / $16.72
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$28.08 / $28.08 / $28.08
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 / $16.30
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$134.22 / $136.52 / $136.52
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$161.27 / $161.27 / $216.38
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.27 / $19.73 / $28.08
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.38 / $25.27 / $32.58
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.27 / $18.75 / $28.08
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.91 / $11.91 / $17.39
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.70 / $15.82 / $19.34
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.57 / $15.65 / $28.08