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Wisconsin rates for HCPCS L6647

Upper extremity addition, shoulder lock mechanism, body powered actuator

Facilitymedian $646 · 10th–90th $575–$1,1750%50%10th90th$646Professionalmedian $457 · 10th–90th $275–$9550%10%20%10th90th$457$0.5$2.0$10.0$50.0$200.0$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$316.23 / $316.23 / $316.23
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $316.23 / $524.81
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$645.65 / $645.65 / $1,047.13
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$575.44 / $588.84 / $707.95
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$407.38 / $1,479.11 / $3,162.28
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$295.12 / $912.01 / $1,202.26
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$309.03 / $512.86 / $794.33
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$363.08 / $616.60 / $758.58
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$316.23 / $630.96 / $2,951.21
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$288.40 / $398.11 / $707.95
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $70.79 / $426.58
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,000.00 / $1,000.00 / $1,000.00
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$457.09 / $724.44 / $1,258.93
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$645.65 / $954.99 / $1,778.28
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$407.38 / $1,258.93 / $2,951.21
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$295.12 / $588.84 / $3,162.28
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$331.13 / $416.87 / $645.65
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$245.47 / $316.23 / $524.81