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Georgia 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 $871 · 10th–90th $355–$3,1620%10%20%10th90th$871Professionalmedian $513 · 10th–90th $355–$8320%10%20%10th90th$513$1.0$5.0$20.0$100.0$500.0$2.0K$10.0K

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
$354.81 / $354.81 / $1,047.13
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$354.81 / $467.74 / $776.25
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$870.96 / $2,089.30 / $3,162.28
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$512.86 / $707.95 / $1,071.52
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$724.44 / $724.44 / $724.44
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$724.44 / $724.44 / $724.44
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 / $1,096.48
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$602.56 / $870.96 / $1,698.24
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$309.03 / $602.56 / $691.83
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$281.84 / $426.58 / $831.76