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Hawaii rates for HCPCS L6628

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

Facilitymedian $389 · 10th–90th $380–$4570%50%10th90th$389Professionalmedian $427 · 10th–90th $251–$5500%20%10th90th$427$200.0$500.0$1.0K

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
Professional
Modifier
Typical Low / Median / Typical High
$251.19 / $354.81 / $549.54
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$389.05 / $446.68 / $446.68
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$446.68 / $457.09 / $616.60
HMSA
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$501.19 / $501.19 / $524.81
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$302.00 / $501.19 / $575.44
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$380.19 / $389.05 / $457.09
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$338.84 / $436.52 / $616.60