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Utah rates for HCPCS L6621

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

Facilitymedian $1,778 · 10th–90th $794–$2,8180%20%40%10th90th$1,778Professionalmedian $1,995 · 10th–90th $794–$11,7490%10%10th90th$1,995$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$794.33 / $794.33 / $794.33
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$794.33 / $1,479.11 / $11,748.98
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,778.28 / $1,778.28 / $1,778.28
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,318.26 / $1,318.26 / $1,778.28
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $2,041.74 / $2,630.27
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,630.27 / $2,818.38 / $2,818.38
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,905.46 / $1,995.26 / $3,019.95
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,691.53 / $2,818.38 / $2,818.38
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,995.26 / $2,818.38 / $3,311.31
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,023.29 / $1,621.81 / $1,862.09
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$954.99 / $1,230.27 / $2,041.74