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Utah rates for HCPCS L6647

Upper extremity addition, shoulder lock mechanism, body powered actuator

Facilitymedian $407 · 10th–90th $182–$6310%20%40%10th90th$407Professionalmedian $457 · 10th–90th $182–$2,6300%10%10th90th$457$50.0$100.0$200.0$500.0$1.0K$2.0K

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
$181.97 / $181.97 / $181.97
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$181.97 / $338.84 / $2,630.27
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$407.38 / $407.38 / $407.38
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$295.12 / $295.12 / $407.38
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $467.74 / $588.84
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$602.56 / $630.96 / $630.96
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$436.52 / $457.09 / $691.83
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$616.60 / $630.96 / $645.65
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$457.09 / $645.65 / $741.31
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$234.42 / $371.54 / $416.87
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$218.78 / $281.84 / $467.74