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Wisconsin rates for HCPCS L2622

Addition to lower extremity, pelvic control, hip joint, adjustable flexion, each

Facilitymedian $389 · 10th–90th $316$7080%20%40%10th90th$389Professionalmedian $251 · 10th–90th $182$5890%20%10th90th$251$0.5$2.0$10.0$50.0$200.0$1.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$194.98 / $194.98 / $194.98
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$169.82 / $199.53 / $281.84
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$389.05 / $389.05 / $645.65
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$295.12 / $363.08 / $426.58
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$213.80 / $891.25 / $1,905.46
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$158.49 / $549.54 / $741.31
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$194.98 / $316.23 / $478.63
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$346.74 / $489.78 / $616.60
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$194.98 / $380.19 / $1,862.09
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$169.82 / $199.53 / $436.52
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $70.79 / $398.11
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$616.60 / $616.60 / $616.60
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$275.42 / $436.52 / $758.58
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$389.05 / $588.84 / $1,096.48
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$213.80 / $776.25 / $2,187.76
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$158.49 / $316.23 / $2,884.03
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$131.83 / $199.53 / $389.05
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$134.90 / $190.55 / $331.13