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Utah rates for HCPCS L6641

Upper extremity addition, excursion amplifier, pulley type

Facilitymedian $126 · 10th–90th $62–$1950%20%40%10th90th$126Professionalmedian $141 · 10th–90th $62–$1,0470%10%10th90th$141$50.0$100.0$200.0$500.0$1.0K

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
$61.66 / $61.66 / $61.66
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$61.66 / $114.82 / $1,047.13
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $93.33 / $125.89
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $141.25 / $181.97
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$186.21 / $194.98 / $194.98
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $138.04 / $218.78
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$194.98 / $194.98 / $208.93
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $199.53 / $251.19
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$79.43 / $120.23 / $144.54
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $95.50 / $154.88