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North Dakota 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 $661 · 10th–90th $525–$1,3490%20%40%10th90th$661Professionalmedian $776 · 10th–90th $380–$1,0960%10%20%10th90th$776$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$660.69 / $660.69 / $794.33
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$380.19 / $478.63 / $891.25
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$758.58 / $1,000.00 / $1,096.48
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
$524.81 / $1,096.48 / $1,380.38
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$389.05 / $794.33 / $1,995.26
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$363.08 / $457.09 / $912.01
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$524.81 / $524.81 / $1,318.26
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$331.13 / $616.60 / $1,122.02