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Michigan rates for HCPCS L6628

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

Facilitymedian $776 · 10th–90th $389–$2,7540%10%20%10th90th$776Professionalmedian $363 · 10th–90th $257–$6920%20%10th90th$363$0.5$2.0$10.0$50.0$200.0$1.0K$5.0K

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
$389.05 / $389.05 / $389.05
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$251.19 / $346.74 / $457.09
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$912.01 / $2,089.30 / $3,981.07
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$691.83 / $691.83 / $724.44
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$371.54 / $371.54 / $371.54
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$446.68 / $446.68 / $446.68
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$323.59 / $446.68 / $707.95
Health Alliance Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$389.05 / $1,318.26 / $1,445.44
Health Alliance Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$346.74 / $549.54 / $831.76
Priority Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$446.68 / $446.68 / $446.68
Priority Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$323.59 / $457.09 / $645.65
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$380.19 / $562.34 / $776.25
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$239.88 / $323.59 / $457.09