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Missouri 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 $741 · 10th–90th $417–$1,9050%20%10th90th$741Professionalmedian $501 · 10th–90th $363–$8510%20%10th90th$501$1.0$5.0$20.0$100.0$500.0$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$407.38 / $602.56 / $602.56
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$346.74 / $467.74 / $851.14
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$912.01 / $912.01 / $3,235.94
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$478.63 / $512.86 / $851.14
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$549.54 / $549.54 / $912.01
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
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$446.68 / $724.44 / $1,995.26
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$316.23 / $457.09 / $4,570.88
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$524.81 / $741.31 / $741.31
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$331.13 / $446.68 / $645.65