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Idaho 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 $813 · 10th–90th $525–$1,0720%20%10th90th$813Professionalmedian $631 · 10th–90th $372–$9550%10%10th90th$631$50.0$100.0$200.0$500.0$1.0K

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
$371.54 / $524.81 / $794.33
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$676.08 / $831.76 / $1,380.38
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$912.01 / $954.99 / $954.99
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$524.81 / $524.81 / $588.84
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$389.05 / $389.05 / $524.81
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$257.04 / $724.44 / $977.24
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$562.34 / $831.76 / $870.96
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $741.31
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$812.83 / $831.76 / $831.76
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$616.60 / $616.60 / $912.01
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$676.08 / $870.96 / $933.25
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$524.81 / $602.56 / $616.60
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$371.54 / $398.11 / $616.60