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Wrist Disarticulation Prosthesis, Myoelectric Control

Utah rates for HCPCS L6925

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

Rates data updated July 2026.

Facilitymedian $5,129 · 10th–90th $2,951$10,4710%20%40%10th90th$5,129Professionalmedian $6,310 · 10th–90th $2,951$44,6680%10%10th90th$6,310$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$2,951.21
Median
$2,951.21
Typical High
$2,951.21
Aetna
Setting
Professional
Modifier
Global
Typical Low
$2,951.21
Median
$4,073.80
Typical High
$44,668.36
Cigna
Setting
Facility
Modifier
Global
Typical Low
$7,244.36
Median
$7,244.36
Typical High
$7,244.36
Cigna
Setting
Professional
Modifier
Global
Typical Low
$5,248.07
Median
$5,248.07
Typical High
$7,244.36
Molina
Setting
Professional
Modifier
Global
Typical Low
$60.26
Median
$7,585.78
Typical High
$9,772.37
Regence BlueShield
Setting
Facility
Modifier
Global
Typical Low
$10,000.00
Median
$10,471.29
Typical High
$10,471.29
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$5,888.44
Median
$7,413.10
Typical High
$11,481.54
Select Health
Setting
Facility
Modifier
Global
Typical Low
$10,715.19
Median
$10,715.19
Typical High
$10,715.19
Select Health
Setting
Professional
Modifier
Global
Typical Low
$5,370.32
Median
$10,471.29
Typical High
$10,715.19
U of Utah Health Plan
Setting
Professional
Modifier
Global
Typical Low
$7,585.78
Median
$10,715.19
Typical High
$12,589.25
United
Setting
Facility
Modifier
Global
Typical Low
$3,801.89
Median
$6,165.95
Typical High
$7,244.36
United
Setting
Professional
Modifier
Global
Typical Low
$3,630.78
Median
$4,570.88
Typical High
$7,079.46