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Maine 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 $1,122 · 10th–90th $525–$1,2880%20%40%10th90th$1,122Professionalmedian $513 · 10th–90th $380–$9550%10%20%10th90th$513$500.0$1.0K$2.0K$5.0K

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 / $467.74 / $1,445.44
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$933.25 / $1,122.02 / $1,288.25
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$512.86 / $512.86 / $954.99
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 / $524.81
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$831.76 / $831.76 / $1,000.00
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$380.19 / $501.19 / $630.96
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$257.04 / $524.81 / $524.81
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$331.13 / $812.83 / $831.76