go back

Indiana rates for HCPCS L6629

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

Facilitymedian $240 · 10th–90th $107$2510%20%40%10th90th$240Professionalmedian $112 · 10th–90th $81$1580%20%40%10th90th$112$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
$112.20 / $112.20 / $112.20
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $112.20 / $141.25
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$107.15 / $239.88 / $295.12
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $107.15 / $190.55
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$173.78 / $229.09 / $263.03
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$112.20 / $112.20 / $239.88
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$83.18 / $83.18 / $199.53
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$114.82 / $131.83 / $190.55
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$58.88 / $114.82 / $165.96