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North Carolina 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 $631 · 10th–90th $347–$1,5850%20%10th90th$631Professionalmedian $603 · 10th–90th $372–$6460%20%40%10th90th$603$1.0$10.0$100.0$1.0K$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
$630.96 / $630.96 / $630.96
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$363.08 / $562.34 / $630.96
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$645.65 / $645.65 / $724.44
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 / $562.34
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$407.38 / $436.52 / $575.44
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$346.74 / $691.83 / $1,230.27
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.60 / $0.60 / $0.60
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$331.13 / $602.56 / $691.83
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$331.13 / $426.58 / $616.60
Wellcare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,265.80 / $4,265.80 / $4,265.80
Wellcare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,570.88 / $4,570.88 / $6,025.60