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Georgia 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 $724 · 10th–90th $295–$2,6920%10%20%10th90th$724Professionalmedian $427 · 10th–90th $295–$6920%10%20%10th90th$427$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
$295.12 / $295.12 / $870.96
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$295.12 / $389.05 / $645.65
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$724.44 / $1,737.80 / $2,691.53
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$426.58 / $588.84 / $912.01
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$602.56 / $602.56 / $602.56
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$602.56 / $602.56 / $602.56
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$562.34 / $562.34 / $562.34
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$407.38 / $407.38 / $912.01
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$512.86 / $724.44 / $1,479.11
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$257.04 / $501.19 / $575.44
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$234.42 / $354.81 / $691.83