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Upper Extremity Addition, Excursion Amplifier, Pulley Type

Wisconsin rates for HCPCS L6641

Upper extremity addition, excursion amplifier, pulley type

Rates data updated July 2026.

Facilitymedian $240 · 10th–90th $182$4370%20%40%10th90th$240Professionalmedian $224 · 10th–90th $117$3890%20%10th90th$224$0.2$1.0$5.0$20.0$100.0$500.0

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
Setting
Facility
Modifier
Global
Typical Low
$120.23
Median
$120.23
Typical High
$120.23
Aetna
Setting
Professional
Modifier
Global
Typical Low
$120.23
Median
$120.23
Typical High
$190.55
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$239.88
Median
$239.88
Typical High
$398.11
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$218.78
Median
$223.87
Typical High
$269.15
Cigna
Setting
Facility
Modifier
Global
Typical Low
$125.89
Median
$562.34
Typical High
$1,230.27
Cigna
Setting
Professional
Modifier
Global
Typical Low
$93.33
Median
$346.74
Typical High
$457.09
DeanCare
Setting
Facility
Modifier
Global
Typical Low
$117.49
Median
$194.98
Typical High
$295.12
DeanCare
Setting
Professional
Modifier
Global
Typical Low
$213.80
Median
$257.04
Typical High
$309.03
Medica
Setting
Facility
Modifier
Global
Typical Low
$120.23
Median
$234.42
Typical High
$1,047.13
Medica
Setting
Professional
Modifier
Global
Typical Low
$107.15
Median
$141.25
Typical High
$269.15
Molina
Setting
Professional
Modifier
Global
Typical Low
$54.95
Median
$70.79
Typical High
$158.49
Network Health
Setting
Facility
Modifier
Global
Typical Low
$380.19
Median
$380.19
Typical High
$380.19
Network Health
Setting
Professional
Modifier
Global
Typical Low
$169.82
Median
$269.15
Typical High
$478.63
Prevea360
Setting
Facility
Modifier
Global
Typical Low
$117.49
Median
$194.98
Typical High
$295.12
Prevea360
Setting
Professional
Modifier
Global
Typical Low
$134.90
Median
$234.42
Typical High
$239.88
Quartz
Setting
Professional
Modifier
Global
Typical Low
$239.88
Median
$363.08
Typical High
$575.44
Quartz
Setting
Facility
Modifier
Global
Typical Low
$125.89
Median
$489.78
Typical High
$1,071.52
Quartz
Setting
Professional
Modifier
Global
Typical Low
$93.33
Median
$363.08
Typical High
$1,258.93
United
Setting
Facility
Modifier
Global
Typical Low
$114.82
Median
$144.54
Typical High
$239.88
United
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$117.49
Typical High
$208.93