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North Carolina rates for HCPCS L6628

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

Facilitymedian $457 · 10th–90th $251–$1,1480%20%10th90th$457Professionalmedian $427 · 10th–90th $251–$4790%20%40%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
$426.58 / $426.58 / $426.58
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$251.19 / $426.58 / $478.63
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$478.63 / $478.63 / $575.44
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$436.52 / $436.52 / $478.63
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$257.04 / $446.68 / $446.68
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$323.59 / $323.59 / $457.09
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$288.40 / $309.03 / $436.52
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$239.88 / $489.78 / $831.76
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.60 / $0.60 / $0.60
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$239.88 / $436.52 / $467.74
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$239.88 / $288.40 / $446.68
Wellcare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,090.30 / $3,090.30 / $3,090.30
Wellcare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,890.45 / $3,890.45 / $4,265.80