go back

Virginia 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 $851 · 10th–90th $447–$1,0720%20%40%10th90th$851Professionalmedian $479 · 10th–90th $380–$8320%20%10th90th$479$1.0$5.0$20.0$100.0$500.0$2.0K$10.0K

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
$446.68 / $446.68 / $446.68
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$380.19 / $446.68 / $707.95
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$851.14 / $851.14 / $912.01
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$512.86 / $512.86 / $1,071.52
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$512.86 / $512.86 / $588.84
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$398.11 / $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
$645.65 / $851.14 / $1,202.26
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$436.52 / $575.44 / $575.44
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$346.74 / $616.60 / $1,000.00
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$457.09 / $501.19 / $562.34
Sentara
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$489.78 / $741.31 / $2,511.89
Sentara
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$489.78 / $741.31 / $2,511.89
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$309.03 / $602.56 / $1,096.48
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$398.11 / $416.87 / $660.69