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Wisconsin rates for HCPCS L2624

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

Facilitymedian $479 · 10th–90th $275–$8710%20%40%10th90th$479Professionalmedian $282 · 10th–90th $186–$7240%20%10th90th$282$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
$234.42 / $275.42 / $275.42
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$177.83 / $234.42 / $323.59
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$478.63 / $478.63 / $794.33
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$398.11 / $446.68 / $524.81
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$288.40 / $1,096.48 / $2,344.23
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $676.08 / $912.01
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$223.87 / $389.05 / $588.84
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$426.58 / $575.44 / $724.44
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$239.88 / $467.74 / $1,995.26
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $234.42 / $512.86
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $70.79 / $467.74
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$758.58 / $758.58 / $758.58
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$338.84 / $537.03 / $933.25
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$478.63 / $724.44 / $1,174.90
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$288.40 / $954.99 / $2,344.23
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $426.58 / $3,630.78
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $218.78 / $478.63
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $234.42 / $389.05