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Michigan 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 $1,096 · 10th–90th $525–$3,8020%20%10th90th$1,096Professionalmedian $479 · 10th–90th $372–$9550%20%10th90th$479$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
$537.03 / $537.03 / $537.03
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$354.81 / $467.74 / $630.96
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,258.93 / $2,884.03 / $5,495.41
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$954.99 / $954.99 / $1,000.00
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$549.54 / $549.54 / $549.54
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 / $524.81 / $1,000.00
Health Alliance Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$537.03 / $1,819.70 / $1,995.26
Health Alliance Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$467.74 / $758.58 / $1,148.15
Priority Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$524.81 / $524.81 / $524.81
Priority Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$389.05 / $524.81 / $794.33
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$524.81 / $776.25 / $1,096.48
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$331.13 / $446.68 / $630.96