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New Hampshire rates for HCPCS L6628

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

Facilitymedian $692 · 10th–90th $380–$8320%10%20%10th90th$692Professionalmedian $457 · 10th–90th $295–$6310%20%10th90th$457$100.0$200.0$500.0$1.0K$2.0K

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
$380.19 / $380.19 / $457.09
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$251.19 / $363.08 / $588.84
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$691.83 / $741.31 / $851.14
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$346.74 / $346.74 / $363.08
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$446.68 / $446.68 / $501.19
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$323.59 / $323.59 / $446.68
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$602.56 / $602.56 / $1,096.48
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$107.15 / $380.19 / $436.52
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $436.52 / $602.56
Well Sense
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$660.69 / $660.69 / $977.24