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Arizona rates for HCPCS L6629

Upper extremity addition, quick disconnect lamination collar with coupling piece, Otto Bock or equal

Facilitymedian $170 · 10th–90th $56–$4470%10%10th90th$170Professionalmedian $105 · 10th–90th $76–$1950%20%10th90th$105$0.2$1.0$5.0$20.0$100.0$500.0

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
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $104.71 / $194.98
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$134.90 / $134.90 / $134.90
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$54.95 / $229.09 / $426.58
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $208.93 / $398.11
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$112.20 / $112.20 / $112.20
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$83.18 / $83.18 / $112.20
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$56.23 / $147.91 / $912.01
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $87.10 / $1,096.48
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$75.86 / $134.90 / $169.82
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$69.18 / $87.10 / $131.83