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Massachusetts 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 $501 · 10th–90th $417–$2,9510%20%40%10th90th$501Professionalmedian $603 · 10th–90th $380–$9330%20%10th90th$603$1.0$10.0$100.0$1.0K$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
$416.87 / $416.87 / $416.87
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$354.81 / $457.09 / $794.33
AllWays Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$891.25 / $933.25 / $4,265.80
AllWays Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$407.38 / $741.31 / $1,071.52
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 / $575.44
Fallon Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$60.26 / $3,630.78 / $9,772.37
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$831.76 / $831.76 / $1,258.93
Health New England
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$707.95 / $707.95 / $707.95
Mass General Brigham
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$891.25 / $933.25 / $4,265.80
Mass General Brigham
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$407.38 / $741.31 / $1,071.52
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$257.04 / $602.56 / $1,096.48
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$398.11 / $616.60 / $831.76