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Pennsylvania rates for HCPCS L6920

Wrist disarticulation, external power, self-suspended inner socket, removable forearm shell, Otto Bock or equal switch, cables, two batteries and one charger, switch control of terminal device

Facilitymedian $9,333 · 10th–90th $4,169–$15,8490%20%10th90th$9,333Professionalmedian $4,786 · 10th–90th $3,467–$7,7620%20%40%10th90th$4,786$1.0$10.0$100.0$1.0K$10.0K

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
$4,168.69 / $15,848.93 / $15,848.93
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,467.37 / $4,570.88 / $7,079.46
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,011.87 / $8,511.38 / $77,624.71
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5,128.61 / $7,585.78 / $9,332.54
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,606.93 / $6,606.93 / $8,128.31
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,786.30 / $4,786.30 / $6,606.93
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7,585.78 / $10,715.19 / $15,488.17
Geisinger
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$9,332.54 / $9,332.54 / $9,332.54
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5,623.41 / $6,165.95 / $9,332.54
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,168.69 / $4,168.69 / $4,168.69
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,467.37 / $4,786.30 / $7,079.46
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.60 / $10,964.78 / $15,848.93
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,466.84 / $4,466.84 / $8,709.64
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,466.84 / $4,466.84 / $8,912.51
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,630.78 / $10,964.78 / $12,589.25
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,890.45 / $5,011.87 / $8,317.64