Upper extremity excursion amplifier add-on, lever type

Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.

Model: claude-haiku-5-5
Provider: anthropic
API: message_batches
Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

Excursion amplifier lever ty

Payers reporting HCPCS L6642

Payer pricing summary

Low

$83

Average

$372

Median

$328

High

$999

Payer rate distribution

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#
1	Aetna fee schedule · outpatient · +10 other terms	359	$287	$346	$178	51%	—	$128 – $1.9k
2	UnitedHealthcare fee schedule · outpatient · +10 other terms	356	$282	$298	$74	25%	—	$130 – $943
3	Humana fee schedule · outpatient · +9 other terms	317	$279	$427	$457	107%	—	$185 – $2.2k
4	Blue Cross Blue Shield fee schedule · outpatient · +8 other terms	218	$284	$399	$247	62%	—	$0 – $1.5k
5	WellCare fee schedule · outpatient · +4 other terms	208	$293	$306	$73	24%	—	$261 – $692
6	Devoted fee schedule · outpatient · +3 other terms	165	$266	$281	$14	5%	—	$256 – $362
7	Molina fee schedule · outpatient · +4 other terms	138	$414	$402	$149	37%	—	$207 – $745
8	Cigna Healthspring fee schedule · outpatient · +1 other terms	116	$285	$287	$17	6%	—	$266 – $365
9	Cigna fee schedule · outpatient · +7 other terms	102	$280	$334	$127	38%	—	$256 – $1.0k
10	Anthem fee schedule · outpatient · +6 other terms	80	$266	$431	$485	113%	—	$195 – $2.7k
11	Kaiser fee schedule · outpatient · +5 other terms	64	$272	$463	$338	73%	—	$256 – $2.1k
12	Superior Healthplan fee schedule · outpatient	40	$299	$298	$1	0%	—	$279 – $299
13	Clover fee schedule · outpatient · +2 other terms	37	$348	$315	$33	11%	—	$266 – $355
14	Oscar fee schedule · outpatient · +4 other terms	36	$280	$338	$95	28%	—	$279 – $556
15	Ambetter facility · fee schedule · outpatient · +6 other terms	35	$587	$554	$103	19%	—	$261 – $687
16	Optum fee schedule · outpatient · +2 other terms	33	$266	$373	$152	41%	—	$256 – $711
17	Caresource fee schedule · outpatient · +5 other terms	28	$266	$326	$122	37%	—	$195 – $549
18	Medica facility · fee schedule · outpatient · +5 other terms	22	$363	$326	$86	26%	—	$118 – $545
19	Regence facility · fee schedule · outpatient · +3 other terms	19	$277	$273	$12	4%	—	$237 – $282
20	Amerihealth Caritas fee schedule · outpatient · +1 other terms	18	$319	$318	$8	3%	—	$303 – $334
21	Bcbs Tx fee schedule · outpatient	18	$279	$279	—	—	—	$279 – $279
22	Medicare fee schedule · outpatient · +1 other terms	18	$256	$257	$2	1%	—	$256 – $261
23	Medical Mutual facility · fee schedule · outpatient · +1 other terms	15	$355	$406	$102	25%	—	$193 – $561
24	Bcbs Mn fee schedule · outpatient · +6 other terms	13	$323	$323	$75	23%	—	$157 – $378
25	Wellmark fee schedule · both · +1 other terms	13	$314	$313	$9	3%	—	$258 – $314

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