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Washington 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 $1,738$6,6070%20%10th90th$2,754Professionalmedian $1,905 · 10th–90th $1,202$3,9810%20%10th90th$1,905$1.0$5.0$20.0$100.0$500.0$2.0K$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
$1,737.80 / $1,737.80 / $4,168.69
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,174.90 / $1,479.11 / $2,454.71
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,344.23 / $2,630.27 / $2,630.27
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,344.23 / $2,344.23 / $3,019.95
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
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,548.82 / $3,630.78 / $7,585.78
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,548.82 / $3,235.94 / $5,754.40
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $2,089.30 / $2,290.87
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,630.27 / $2,691.53 / $2,754.23
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,344.23 / $3,981.07 / $5,370.32
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,238.72 / $2,238.72 / $2,630.27
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,630.27 / $2,630.27 / $2,630.27
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,344.23 / $2,344.23 / $3,019.95
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,621.81 / $3,981.07 / $3,981.07
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,148.15 / $1,659.59 / $2,344.23
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,479.11 / $1,905.46 / $4,168.69