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Delaware rates for HCPCS L6628

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$249.10 / $270.89 / $307.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$444.49 / $444.49 / $444.49
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$324.48 / $324.48 / $444.49
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$108.00 / $108.00 / $108.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$296.50 / $351.84 / $1,204.09