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Oregon 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 $832 · 10th–90th $646–$9120%50%10th90th$832Professionalmedian $525 · 10th–90th $372–$9550%10%10th90th$525$100.0$500.0$2.0K$10.0K$50.0K

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
$524.81 / $524.81 / $524.81
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$363.08 / $478.63 / $776.25
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 / $389.05
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$660.69 / $1,778.28 / $2,137.96
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$524.81 / $645.65 / $933.25
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$630.96 / $691.83 / $933.25
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$831.76 / $851.14 / $891.25
Pacific Source
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$676.08 / $676.08 / $676.08
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$457.09 / $724.44 / $1,000.00
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $758.58 / $891.25
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$724.44 / $1,380.38 / $3,388.44
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$870.96 / $954.99 / $954.99
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$309.03 / $616.60 / $1,318.26
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$331.13 / $398.11 / $758.58