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Utah rates for HCPCS L6638

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

Facilitymedian $1,950 · 10th–90th $871–$3,0200%20%40%10th90th$1,950Professionalmedian $2,188 · 10th–90th $871–$12,8820%10%10th90th$2,188$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
$870.96 / $870.96 / $870.96
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$870.96 / $1,621.81 / $12,882.50
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,949.84 / $1,949.84 / $1,949.84
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,412.54 / $1,412.54 / $1,949.84
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $2,238.72 / $2,884.03
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,884.03 / $3,019.95 / $3,019.95
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,089.30 / $2,187.76 / $3,311.31
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,951.21 / $3,019.95 / $3,090.30
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,187.76 / $3,090.30 / $3,630.78
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,122.02 / $1,778.28 / $2,041.74
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,047.13 / $1,348.96 / $2,238.72