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Illinois 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 $1,072 · 10th–90th $468–$4,8980%20%10th90th$1,072Professionalmedian $525 · 10th–90th $380–$9770%20%10th90th$525$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
$467.74 / $467.74 / $977.24
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$363.08 / $467.74 / $891.25
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,148.15 / $1,778.28 / $6,606.93
BCBS
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 / $1,000.00
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$389.05 / $389.05 / $1,096.48
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$812.83 / $1,023.29 / $1,288.25
Hally Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,230.27 / $1,230.27 / $1,230.27
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$537.03 / $537.03 / $758.58
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$537.03 / $776.25 / $1,318.26
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$363.08 / $478.63 / $794.33