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Missouri rates for HCPCS L6628

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

Facilitymedian $575 · 10th–90th $324–$1,3800%20%10th90th$575Professionalmedian $355 · 10th–90th $257–$6760%20%10th90th$355$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 / $478.63 / $478.63
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$251.19 / $346.74 / $676.08
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$724.44 / $724.44 / $2,511.89
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$346.74 / $363.08 / $660.69
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$436.52 / $436.52 / $724.44
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$446.68 / $446.68 / $467.74
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$323.59 / $323.59 / $446.68
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$323.59 / $549.54 / $1,584.89
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$234.42 / $354.81 / $3,801.89
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$380.19 / $575.44 / $575.44
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$239.88 / $338.84 / $512.86