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Iowa rates for HCPCS L6629

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

Facilitymedian $195 · 10th–90th $123–$5010%10%20%10th90th$195Professionalmedian $115 · 10th–90th $76–$2090%10%20%10th90th$115$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
Facility
Modifier
Typical Low / Median / Typical High
$141.25 / $141.25 / $194.98
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $114.82 / $151.36
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$112.20 / $112.20 / $204.17
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $269.15 / $338.84
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$173.78 / $223.87 / $234.42
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$123.03 / $234.42 / $912.01
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $131.83 / $338.84
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$199.53 / $208.93 / $269.15
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$204.17 / $204.17 / $204.17
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$199.53 / $302.00 / $302.00
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$75.86 / $186.21 / $467.74
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $100.00 / $194.98
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$141.25 / $177.83 / $177.83