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Kansas rates for HCPCS L6628

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$588.84 / $588.84 / $588.84
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$251.19 / $371.54 / $549.54
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$588.84 / $630.96 / $660.69
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$691.83 / $691.83 / $691.83
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$446.68 / $446.68 / $446.68
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$323.59 / $323.59 / $794.33
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$186.21 / $489.78 / $1,584.89
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$190.55 / $354.81 / $3,801.89
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$380.19 / $562.34 / $562.34
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$234.42 / $354.81 / $467.74