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Nebraska 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 $933 · 10th–90th $525–$4,1690%10%20%10th90th$933Professionalmedian $575 · 10th–90th $324–$2,3990%10%20%10th90th$575$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
$575.44 / $575.44 / $575.44
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$257.04 / $575.44 / $4,073.80
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$794.33 / $870.96 / $870.96
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$524.81 / $524.81 / $1,000.00
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$524.81 / $1,096.48 / $1,548.82
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$575.44 / $977.24 / $4,168.69
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$302.00 / $524.81 / $870.96
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$977.24 / $1,000.00 / $2,398.83
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,000.00 / $1,000.00 / $1,000.00
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,258.93 / $2,238.72 / $2,398.83
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$524.81 / $616.60 / $933.25
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$323.59 / $446.68 / $707.95