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Idaho 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 $676 · 10th–90th $437–$8910%20%10th90th$676Professionalmedian $537 · 10th–90th $309–$8130%10%10th90th$537$50.0$100.0$200.0$500.0$1.0K

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
Professional
Modifier
Typical Low / Median / Typical High
$309.03 / $436.52 / $660.69
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$575.44 / $691.83 / $1,148.15
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$758.58 / $812.83 / $812.83
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$489.78 / $562.34 / $588.84
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$407.38 / $407.38 / $562.34
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$213.80 / $602.56 / $812.83
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$467.74 / $691.83 / $724.44
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $616.60
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$676.08 / $691.83 / $691.83
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$512.86 / $512.86 / $758.58
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$575.44 / $724.44 / $776.25
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$436.52 / $501.19 / $512.86
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$309.03 / $331.13 / $512.86