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Virginia rates for HCPCS L6628

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

Facilitymedian $676 · 10th–90th $347–$8320%20%40%10th90th$676Professionalmedian $347 · 10th–90th $269–$5890%20%40%10th90th$347$0.5$2.0$10.0$50.0$200.0$1.0K$5.0K

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
$346.74 / $346.74 / $346.74
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$257.04 / $346.74 / $478.63
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$676.08 / $676.08 / $707.95
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$346.74 / $346.74 / $724.44
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$354.81 / $354.81 / $457.09
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$288.40 / $446.68 / $446.68
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$323.59 / $323.59 / $436.52
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$501.19 / $676.08 / $933.25
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$309.03 / $436.52 / $660.69
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$245.47 / $436.52 / $776.25
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$338.84 / $363.08 / $436.52
Sentara
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$380.19 / $549.54 / $1,445.44
Sentara
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$380.19 / $549.54 / $1,445.44
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$218.78 / $426.58 / $676.08
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$295.12 / $331.13 / $524.81