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Ohio rates for HCPCS L6629

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$114.32 / $114.32 / $230.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$86.11 / $114.32 / $133.71
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$219.85 / $257.54 / $667.27
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$105.47 / $114.22 / $304.36
Aultcare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$199.01 / $199.01 / $199.01
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$149.26 / $234.13 / $316.08
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$152.18 / $210.72 / $501.32
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$113.00 / $113.00 / $225.54
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$82.49 / $82.49 / $144.36
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Low / Median / High Price
$113.00 / $113.00 / $113.00
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Low / Median / High Price
$82.49 / $113.00 / $113.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$99.32 / $136.57 / $179.05
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$73.01 / $116.81 / $148.62