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Florida rates for HCPCS L6695

Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, not for use with locking mechanism

Facilitymedian $347 · 10th–90th $302–$5750%20%40%10th90th$347Professionalmedian $372 · 10th–90th $302–$5620%20%10th90th$372$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
$302.00 / $323.59 / $371.54
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$302.00 / $371.54 / $549.54
AvMed
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$724.44 / $724.44 / $724.44
AvMed
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$537.03 / $676.08 / $724.44
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$562.34 / $562.34 / $1,202.26
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$407.38 / $407.38 / $562.34
Florida Blue
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $436.52 / $724.44
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$575.44 / $575.44 / $575.44
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$302.00 / $501.19 / $912.01
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$302.00 / $354.81 / $501.19
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$426.58 / $426.58 / $724.44