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Maryland 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 $603 · 10th–90th $525–$6170%50%10th90th$603Professionalmedian $447 · 10th–90th $380–$7760%20%10th90th$447$500.0$1.0K$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$380.19 / $446.68 / $776.25
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$512.86 / $512.86 / $588.84
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$524.81 / $524.81 / $549.54
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$389.05 / $389.05 / $524.81
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$602.56 / $851.14 / $1,288.25
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$363.08 / $602.56 / $616.60
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$380.19 / $446.68 / $660.69
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$489.78 / $489.78 / $724.44