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Arizona 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 $776 · 10th–90th $257–$1,8620%10%10th90th$776Professionalmedian $468 · 10th–90th $363–$8710%20%10th90th$468$1.0$5.0$20.0$100.0$500.0$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
$363.08 / $467.74 / $794.33
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$645.65 / $645.65 / $645.65
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$245.47 / $1,023.29 / $1,905.46
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$724.44 / $933.25 / $1,819.70
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 / $524.81
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$257.04 / $602.56 / $1,905.46
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$363.08 / $398.11 / $4,570.88
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$524.81 / $776.25 / $776.25
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$316.23 / $398.11 / $602.56