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Wyoming rates for HCPCS L6628

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$383.32 / $383.32 / $671.29
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$748.67 / $748.67 / $748.67
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$748.67 / $748.67 / $748.67
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$444.49 / $444.49 / $776.59
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$324.48 / $324.48 / $444.49
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$259.26 / $286.85 / $442.02