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Montana rates for HCPCS L6638

Upper extremity addition to prosthesis, electric locking feature, only for use with manually powered elbow

Facilitymedian $2,951 · 10th–90th $1,950–$3,7150%20%10th90th$2,951Professionalmedian $1,905 · 10th–90th $955–$3,7150%10%20%10th90th$1,905$100.0$200.0$500.0$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$954.99 / $1,778.28 / $2,630.27
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,949.84 / $3,235.94 / $3,235.94
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,949.84 / $3,235.94 / $3,235.94
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,344.23 / $2,951.21 / $5,754.40
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,344.23 / $2,951.21 / $5,754.40
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,445.44 / $2,818.38 / $4,365.16
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $2,398.83 / $3,235.94
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,778.28 / $2,041.74 / $2,137.96
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,202.26 / $1,348.96 / $2,089.30