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Iowa rates for HCPCS L6628

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

Facilitymedian $646 · 10th–90th $447–$1,7380%20%10th90th$646Professionalmedian $363 · 10th–90th $245–$7240%20%10th90th$363$0.5$2.0$10.0$50.0$200.0$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$549.54 / $549.54 / $575.44
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$245.47 / $346.74 / $562.34
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$446.68 / $446.68 / $794.33
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$446.68 / $794.33 / $1,000.00
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$588.84 / $707.95 / $794.33
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$478.63 / $912.01 / $3,019.95
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$331.13 / $446.68 / $1,174.90
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$776.25 / $812.83 / $912.01
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$794.33 / $794.33 / $794.33
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$660.69 / $1,174.90 / $1,174.90
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$239.88 / $724.44 / $1,513.56
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$323.59 / $371.54 / $676.08
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$549.54 / $691.83 / $691.83