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South Dakota rates for HCPCS L6621

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

Facilitymedian $2,291 · 10th–90th $2,042–$4,5710%20%40%10th90th$2,291Professionalmedian $2,291 · 10th–90th $1,202–$3,8020%10%20%10th90th$2,291$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,041.74 / $2,290.87 / $2,290.87
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,202.26 / $2,290.87 / $2,754.23
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,778.28 / $1,778.28 / $3,090.30
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,235.94 / $3,235.94 / $3,981.07
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,238.72 / $2,818.38 / $7,413.10
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,122.02 / $1,862.09 / $13,803.84
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,511.89 / $3,019.95 / $3,019.95
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,090.30 / $3,090.30 / $3,090.30
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,511.89 / $2,511.89 / $5,011.87
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,344.23 / $2,818.38 / $3,715.35
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$954.99 / $1,862.09 / $3,235.94
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,691.53 / $2,691.53 / $2,691.53