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California 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 $468 · 10th–90th $363–$2,1380%20%10th90th$468Professionalmedian $501 · 10th–90th $380–$3,5480%20%10th90th$501$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
Facility
Modifier
Typical Low / Median / Typical High
$478.63 / $478.63 / $4,073.80
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$371.54 / $478.63 / $3,630.78
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$363.08 / $467.74 / $2,041.74
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$478.63 / $512.86 / $1,288.25
Blue Shield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$562.34 / $1,380.38 / $2,187.76
Blue Shield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$891.25 / $1,737.80 / $3,548.13
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
Contra Costa Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$501.19 / $630.96 / $1,148.15
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$575.44 / $870.96 / $1,479.11
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,265.80 / $4,265.80 / $4,265.80
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,570.88 / $6,025.60 / $6,025.60
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$870.96 / $870.96 / $870.96
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$269.15 / $870.96 / $1,202.26
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$389.05 / $389.05 / $831.76
Sutter Health Plus
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,778.28 / $1,778.28 / $1,778.28
The Alliance
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$501.19 / $660.69 / $870.96
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$66.07 / $537.03 / $1,096.48
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$380.19 / $478.63 / $1,023.29