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New York rates for HCPCS L6628

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

Facilitymedian $447 · 10th–90th $76–$1,0470%10%10th90th$447Professionalmedian $347 · 10th–90th $251–$7940%20%40%10th90th$347$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
$208.93 / $467.74 / $660.69
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$223.87 / $331.13 / $549.54
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$588.84 / $588.84 / $1,174.90
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$346.74 / $363.08 / $912.01
CDPHP
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$446.68 / $478.63 / $478.63
CDPHP
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$478.63 / $478.63 / $478.63
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$446.68 / $446.68 / $53,703.18
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$323.59 / $323.59 / $794.33
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$588.84 / $977.24 / $2,238.72
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$363.08 / $588.84 / $1,122.02
Excellus BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$75.86 / $75.86 / $79.43
Excellus BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $346.74 / $363.08
MVP Health Care
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$162.18 / $50,118.72 / $75,857.76
MVP Health Care
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$380.19 / $562.34 / $562.34
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$239.88 / $436.52 / $1,621.81
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$204.17 / $380.19 / $977.24
Univera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$75.86 / $331.13 / $346.74
Univera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $346.74 / $363.08