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Wisconsin rates for HCPCS L6621

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

Facilitymedian $2,818 · 10th–90th $2,512$5,1290%50%10th90th$2,818Professionalmedian $2,042 · 10th–90th $1,202$4,2660%20%10th90th$2,042$2.0$10.0$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,380.38 / $1,380.38 / $1,380.38
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,174.90 / $1,380.38 / $2,290.87
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,818.38 / $2,818.38 / $4,677.35
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,344.23 / $2,630.27 / $3,162.28
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,778.28 / $6,456.54 / $13,803.84
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,318.26 / $3,981.07 / $5,370.32
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,380.38 / $2,290.87 / $3,467.37
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,584.89 / $2,691.53 / $3,388.44
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,380.38 / $2,754.23 / $12,882.50
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,258.93 / $1,778.28 / $3,090.30
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $70.79 / $169.82
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,466.84 / $4,466.84 / $4,466.84
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,995.26 / $3,162.28 / $5,495.41
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,818.38 / $4,265.80 / $7,762.47
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,778.28 / $5,623.41 / $12,882.50
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,318.26 / $2,630.27 / $13,803.84
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,479.11 / $1,862.09 / $2,818.38
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,071.52 / $1,380.38 / $2,290.87