go back

Alaska rates for HCPCS L6628

Upper extremity addition, quick disconnect hook adapter, Otto Bock or equal

Facilitymedian $407 · 10th–90th $186–$5890%20%40%10th90th$407Professionalmedian $447 · 10th–90th $324–$6760%10%20%10th90th$447$100.0$200.0$500.0$1.0K$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
Professional
Modifier
Typical Low / Median / Typical High
$323.59 / $426.58 / $588.84
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$446.68 / $446.68 / $446.68
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$323.59 / $323.59 / $537.03
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$186.21 / $446.68 / $588.84
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$407.38 / $537.03 / $1,513.56
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$446.68 / $446.68 / $602.56
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$371.54 / $446.68 / $575.44
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$186.21 / $186.21 / $588.84
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $446.68 / $537.03
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$380.19 / $380.19 / $436.52
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$229.09 / $288.40 / $1,148.15