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South 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 $603 · 10th–90th $380–$1,1480%10%20%10th90th$603Professionalmedian $468 · 10th–90th $363–$7240%10%20%10th90th$468$50.0$100.0$200.0$500.0$1.0K$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
$380.19 / $380.19 / $380.19
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$363.08 / $457.09 / $630.96
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$602.56 / $851.14 / $1,071.52
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$524.81 / $524.81 / $588.84
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$389.05 / $389.05 / $1,096.48
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$436.52 / $436.52 / $436.52
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$380.19 / $645.65 / $1,380.38
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$257.04 / $257.04 / $263.03
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $575.44
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$524.81 / $602.56 / $1,096.48
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$331.13 / $426.58 / $602.56