go back

Iowa 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 $891 · 10th–90th $575$2,4550%10%20%10th90th$891Professionalmedian $501 · 10th–90th $355$9550%10%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
$660.69 / $707.95 / $794.33
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$354.81 / $467.74 / $724.44
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$524.81 / $524.81 / $1,000.00
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$524.81 / $1,096.48 / $1,380.38
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$851.14 / $954.99 / $1,096.48
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$616.60 / $1,174.90 / $4,168.69
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$426.58 / $602.56 / $1,513.56
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$977.24 / $1,023.29 / $1,230.27
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,000.00 / $1,000.00 / $1,000.00
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$912.01 / $1,513.56 / $1,513.56
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$398.11 / $912.01 / $2,137.96
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$416.87 / $478.63 / $851.14
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$691.83 / $891.25 / $891.25