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Indiana rates for HCPCS L6628

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

Facilitymedian $708 · 10th–90th $324–$7410%50%10th90th$708Professionalmedian $339 · 10th–90th $257–$5370%50%10th90th$339$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
$323.59 / $323.59 / $323.59
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$257.04 / $331.13 / $524.81
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$346.74 / $707.95 / $870.96
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$346.74 / $346.74 / $630.96
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$575.44 / $741.31 / $870.96
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$446.68 / $446.68 / $707.95
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$323.59 / $323.59 / $602.56
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$380.19 / $436.52 / $562.34
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$190.55 / $346.74 / $489.78