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Montana rates for HCPCS L6621

Upper extremity prosthesis addition, flexion/extension wrist with or without friction, for use with external powered terminal device

Facilitymedian $2,754 · 10th–90th $1,778–$3,3880%20%10th90th$2,754Professionalmedian $1,738 · 10th–90th $871–$3,2360%10%20%10th90th$1,738$100.0$200.0$500.0$1.0K$2.0K$5.0K$10.0K

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
Professional
Modifier
Typical Low / Median / Typical High
$870.96 / $1,621.81 / $2,454.71
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,754.23 / $2,754.23 / $2,754.23
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,778.28 / $2,951.21 / $2,951.21
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,778.28 / $2,951.21 / $2,951.21
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,137.96 / $2,754.23 / $5,370.32
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,137.96 / $2,754.23 / $5,370.32
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,318.26 / $2,570.40 / $3,981.07
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $2,187.76 / $2,951.21
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,621.81 / $1,862.09 / $1,949.84
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,122.02 / $1,230.27 / $1,905.46