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Pennsylvania rates for HCPCS L6621

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

Facilitymedian $2,884 · 10th–90th $1,202–$4,6770%20%10th90th$2,884Professionalmedian $1,380 · 10th–90th $1,175–$2,4550%20%40%10th90th$1,380$1.0$10.0$100.0$1.0K$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
Facility
Modifier
Typical Low / Median / Typical High
$1,202.26 / $4,677.35 / $4,677.35
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,174.90 / $1,348.96 / $2,290.87
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,011.87 / $8,511.38 / $77,624.71
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,691.53 / $2,691.53 / $2,691.53
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,778.28 / $1,778.28 / $2,754.23
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,318.26 / $1,318.26 / $1,778.28
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,511.89 / $3,630.78 / $5,248.07
Geisinger
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,754.23 / $2,754.23 / $2,754.23
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,659.59 / $1,905.46 / $2,754.23
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,202.26 / $1,202.26 / $1,202.26
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,174.90 / $1,380.38 / $2,290.87
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.60 / $3,801.89 / $5,370.32
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,905.46 / $1,905.46 / $2,570.40
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,905.46 / $1,905.46 / $2,630.27
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,122.02 / $3,388.44 / $3,890.45
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,148.15 / $1,479.11 / $2,754.23