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South Carolina rates for HCPCS L6628

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

Facilitymedian $437 · 10th–90th $257–$7760%10%20%10th90th$437Professionalmedian $339 · 10th–90th $251–$4790%20%10th90th$339$50.0$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
$257.04 / $257.04 / $257.04
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$251.19 / $346.74 / $457.09
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$338.84 / $575.44 / $676.08
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$257.04 / $446.68 / $489.78
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$323.59 / $323.59 / $794.33
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$309.03 / $309.03 / $398.11
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$257.04 / $467.74 / $891.25
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $186.21 / $186.21
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $389.05
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$380.19 / $436.52 / $776.25
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$223.87 / $288.40 / $436.52