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Tennessee 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 $363–$4,2660%20%10th90th$631Professionalmedian $417 · 10th–90th $363–$7240%20%10th90th$417$1.0$5.0$20.0$100.0$500.0$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
$363.08 / $363.08 / $645.65
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$363.08 / $416.87 / $724.44
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$645.65 / $645.65 / $691.83
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$524.81 / $524.81 / $616.60
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$389.05 / $389.05 / $524.81
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,265.80 / $4,265.80 / $4,265.80
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,570.88 / $6,025.60 / $6,025.60
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$478.63 / $602.56 / $630.96
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$281.84 / $416.87 / $602.56