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Texas rates for HCPCS L6629

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

Facilitymedian $162 · 10th–90th $93$3890%10%10th90th$162Professionalmedian $105 · 10th–90th $78$1860%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
Facility
Modifier
Typical Low / Median / Typical High
$93.33 / $93.33 / $100.00
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $100.00 / $186.21
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $138.04 / $138.04
Christus
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$79.43 / $218.78 / $218.78
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
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$933.25 / $933.25 / $933.25
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,122.02 / $1,584.89 / $1,584.89
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$91.20 / $162.18 / $269.15
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$83.18 / $104.71 / $204.17
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $109.65 / $112.20
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$91.20 / $158.49 / $269.15
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$83.18 / $83.18 / $112.20
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$79.43 / $134.90 / $204.17
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$72.44 / $107.15 / $134.90
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $218.78 / $218.78