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Wisconsin rates for HCPCS L6687

Upper extremity addition, frame type socket, below elbow or wrist disarticulation

Facilitymedian $708 · 10th–90th $575–$1,2880%50%10th90th$708Professionalmedian $525 · 10th–90th $309–$1,0470%10%20%10th90th$525$1.0$5.0$20.0$100.0$500.0$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$346.74 / $346.74 / $346.74
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$302.00 / $346.74 / $588.84
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$707.95 / $707.95 / $1,174.90
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$602.56 / $660.69 / $794.33
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$436.52 / $1,621.81 / $3,467.37
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$316.23 / $1,000.00 / $1,348.96
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$346.74 / $575.44 / $870.96
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$630.96 / $851.14 / $1,047.13
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$346.74 / $691.83 / $3,630.78
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$323.59 / $457.09 / $794.33
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $70.79 / $251.19
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,122.02 / $1,122.02 / $1,122.02
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$501.19 / $794.33 / $1,380.38
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$707.95 / $1,096.48 / $2,187.76
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$436.52 / $1,412.54 / $3,715.35
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$316.23 / $630.96 / $4,570.88
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$346.74 / $524.81 / $707.95
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$288.40 / $346.74 / $588.84