Quick-disconnect hook adapter for upper limb prosthesis

Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.

Model: claude-haiku-5-5
Provider: anthropic
API: message_batches
Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

Quick disconn hook adapter o

Payers reporting HCPCS L6628

Payer pricing summary

Low

$152

Average

$800

Median

$731

High

$1.7k

Payer rate distribution

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#
1	Aetna fee schedule · outpatient · +12 other terms	359	$637	$762	$376	49%	—	$281 – $4.7k
2	UnitedHealthcare fee schedule · outpatient · +13 other terms	356	$635	$652	$175	27%	—	$287 – $2.3k
3	Humana fee schedule · outpatient · +12 other terms	317	$620	$943	$1.0k	107%	—	$366 – $4.9k
4	Blue Cross Blue Shield fee schedule · outpatient · +11 other terms	218	$632	$843	$483	57%	—	$0 – $3.1k
5	WellCare fee schedule · outpatient · +4 other terms	208	$651	$669	$99	15%	—	$575 – $1.1k
6	Devoted fee schedule · outpatient · +3 other terms	165	$632	$643	$52	8%	—	$586 – $797
7	Molina fee schedule · outpatient · +5 other terms	138	$931	$895	$340	38%	—	$414 – $1.7k
8	Cigna Healthspring fee schedule · outpatient · +1 other terms	116	$632	$646	$45	7%	—	$586 – $805
9	Cigna fee schedule · outpatient · +11 other terms	102	$735	$765	$229	30%	—	$575 – $2.1k
10	Anthem fee schedule · outpatient · +8 other terms	80	$767	$964	$926	96%	—	$391 – $5.3k
11	Kaiser fee schedule · outpatient · +6 other terms	64	$798	$1.2k	$803	69%	—	$674 – $5.2k
12	Superior Healthplan fee schedule · outpatient	40	$664	$663	$3	0%	—	$620 – $664
13	Clover fee schedule · outpatient · +2 other terms	37	$586	$609	$43	7%	—	$575 – $782
14	Oscar fee schedule · outpatient · +4 other terms	36	$619	$721	$162	23%	—	$616 – $1.2k
15	Ambetter facility · fee schedule · outpatient · +6 other terms	35	$1.3k	$1.2k	$247	21%	—	$575 – $1.5k
16	Optum fee schedule · outpatient · +2 other terms	33	$751	$871	$312	36%	—	$586 – $1.6k
17	Caresource fee schedule · outpatient · +5 other terms	28	$586	$682	$225	33%	—	$391 – $1.1k
18	Medica facility · fee schedule · outpatient · +5 other terms	22	$717	$664	$176	27%	—	$234 – $1.2k
19	Regence facility · fee schedule · outpatient · +4 other terms	19	$813	$768	$80	10%	—	$590 – $829
20	Amerihealth Caritas fee schedule · outpatient · +1 other terms	18	$704	$696	$14	2%	—	$669 – $704
21	Bcbs Tx fee schedule · outpatient	18	$620	$620	—	—	—	$620 – $620
22	Medicare fee schedule · outpatient · +3 other terms	18	$751	$754	$6	1%	—	$751 – $767
23	Medical Mutual facility · fee schedule · outpatient · +2 other terms	15	$701	$806	$200	25%	—	$382 – $1.1k
24	Bcbs Mn fee schedule · outpatient · +6 other terms	13	$637	$637	$149	23%	—	$310 – $747
25	Wellmark fee schedule · both · +3 other terms	13	$692	$687	$29	4%	—	$510 – $692

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