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Utah rates for HCPCS L6642

Upper extremity addition, excursion amplifier, lever type

Facilitymedian $174 · 10th–90th $83–$2630%20%40%10th90th$174Professionalmedian $191 · 10th–90th $83–$1,3490%5%10%10th90th$191$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
$83.18 / $83.18 / $83.18
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$83.18 / $154.88 / $1,348.96
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$223.87 / $223.87 / $223.87
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$165.96 / $165.96 / $223.87
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $190.55 / $245.47
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$251.19 / $263.03 / $263.03
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $186.21 / $295.12
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$263.03 / $263.03 / $281.84
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $269.15 / $338.84
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$109.65 / $154.88 / $194.98
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $128.82 / $208.93