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Minnesota 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 $794–$6,9180%20%10th90th$1,096Professionalmedian $955 · 10th–90th $457–$1,0960%50%10th90th$955$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
$794.33 / $794.33 / $794.33
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$363.08 / $524.81 / $794.33
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$933.25 / $954.99 / $1,230.27
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$758.58 / $954.99 / $954.99
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,187.76 / $3,548.13 / $8,511.38
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,096.48 / $1,258.93 / $1,412.54
Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,818.38 / $3,548.13 / $6,918.31
Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,096.48 / $1,096.48 / $1,479.11
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$346.74 / $954.99 / $4,168.69
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $398.11 / $1,000.00
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6.46 / $524.81 / $1,318.26
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$316.23 / $501.19 / $1,318.26