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Utah 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 $5,370 · 10th–90th $2,570–$9,7720%20%40%10th90th$5,370Professionalmedian $6,918 · 10th–90th $2,570–$38,9050%5%10%10th90th$6,918$50.0$200.0$1.0K$5.0K$20.0K

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
$2,570.40 / $2,570.40 / $2,570.40
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,570.40 / $4,897.79 / $38,904.51
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,606.93 / $6,606.93 / $6,606.93
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,786.30 / $4,786.30 / $6,606.93
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $7,079.46 / $9,120.11
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$9,332.54 / $9,772.37 / $9,772.37
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6,606.93 / $6,918.31 / $10,471.29
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$9,120.11 / $9,772.37 / $10,000.00
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6,918.31 / $10,000.00 / $11,481.54
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,311.31 / $4,466.84 / $6,025.60
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,162.28 / $3,981.07 / $6,918.31