go back

Massachusetts rates for HCPCS L6628

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

Facilitymedian $398 · 10th–90th $295$2,0420%20%10th90th$398Professionalmedian $427 · 10th–90th $269$6610%20%10th90th$427$0.5$5.0$50.0$500.0$5.0K$50.0K

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
$295.12 / $295.12 / $295.12
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$251.19 / $338.84 / $575.44
AllWays Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$616.60 / $660.69 / $3,090.30
AllWays Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$295.12 / $524.81 / $776.25
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$398.11 / $398.11 / $1,202.26
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$398.11 / $446.68 / $478.63
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$323.59 / $323.59 / $457.09
Fallon Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$60.26 / $3,630.78 / $9,772.37
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$602.56 / $602.56 / $891.25
Health New England
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$363.08 / $363.08 / $363.08
Mass General Brigham
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$616.60 / $660.69 / $3,090.30
Mass General Brigham
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$295.12 / $524.81 / $776.25
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$107.15 / $436.52 / $776.25
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$288.40 / $446.68 / $602.56