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Wisconsin rates for HCPCS L2627

Addition to lower extremity, pelvic control, plastic, molded to patient model, reciprocating hip joint and cables

Facilitymedian $2,630 · 10th–90th $2,138–$4,7860%50%10th90th$2,630Professionalmedian $1,549 · 10th–90th $891–$3,8900%10%20%10th90th$1,549$2.0$10.0$50.0$200.0$1.0K$5.0K

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
$1,288.25 / $1,288.25 / $1,288.25
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$870.96 / $1,288.25 / $1,737.80
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,630.27 / $2,630.27 / $4,365.16
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,344.23 / $2,454.71 / $2,951.21
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,202.26 / $6,025.60 / $12,882.50
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$870.96 / $3,715.35 / $5,011.87
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,202.26 / $2,137.96 / $3,235.94
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,479.11 / $2,344.23 / $3,162.28
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,288.25 / $2,570.40 / $10,232.93
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$954.99 / $1,288.25 / $2,818.38
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $70.79 / $1,174.90
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,168.69 / $4,168.69 / $4,168.69
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,862.09 / $2,951.21 / $5,128.61
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,630.27 / $3,981.07 / $6,025.60
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,202.26 / $5,248.07 / $10,232.93
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$870.96 / $1,778.28 / $12,882.50
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$645.65 / $1,096.48 / $2,630.27
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$851.14 / $1,288.25 / $2,089.30