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Alaska rates for HCPCS L6694

Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, for use with locking mechanism

Facilitymedian $525 · 10th–90th $257–$9770%20%40%10th90th$525Professionalmedian $603 · 10th–90th $447–$1,3800%10%20%10th90th$603$100.0$200.0$500.0$1.0K$2.0K

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
Professional
Modifier
Typical Low / Median / Typical High
$416.87 / $562.34 / $870.96
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$524.81 / $524.81 / $524.81
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$389.05 / $389.05 / $1,288.25
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$257.04 / $630.96 / $977.24
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$537.03 / $977.24 / $2,630.27
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$758.58 / $977.24 / $1,023.29
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$794.33 / $977.24 / $1,023.29
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$257.04 / $257.04 / $954.99
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $524.81 / $812.83
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$524.81 / $524.81 / $602.56
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$426.58 / $501.19 / $1,949.84