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Massachusetts 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 $427 · 10th–90th $347$2,9510%20%40%10th90th$427Professionalmedian $501 · 10th–90th $316$7760%20%10th90th$501$1.0$10.0$100.0$1.0K$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
Setting
Facility
Modifier
Global
Typical Low
$346.74
Median
$346.74
Typical High
$346.74
Aetna
Setting
Professional
Modifier
Global
Typical Low
$295.12
Median
$380.19
Typical High
$660.69
AllWays Health Partners
Setting
Facility
Modifier
Global
Typical Low
$741.31
Median
$776.25
Typical High
$3,548.13
AllWays Health Partners
Setting
Professional
Modifier
Global
Typical Low
$338.84
Median
$616.60
Typical High
$891.25
Cigna
Setting
Facility
Modifier
Global
Typical Low
$562.34
Median
$562.34
Typical High
$562.34
Cigna
Setting
Professional
Modifier
Global
Typical Low
$407.38
Median
$407.38
Typical High
$575.44
Fallon Health
Setting
Facility
Modifier
Global
Typical Low
$60.26
Median
$3,630.78
Typical High
$9,772.37
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$691.83
Median
$691.83
Typical High
$1,047.13
Health New England
Setting
Professional
Modifier
Global
Typical Low
$588.84
Median
$588.84
Typical High
$588.84
Mass General Brigham
Setting
Facility
Modifier
Global
Typical Low
$741.31
Median
$776.25
Typical High
$3,548.13
Mass General Brigham
Setting
Professional
Modifier
Global
Typical Low
$338.84
Median
$616.60
Typical High
$891.25
United
Setting
Facility
Modifier
Global
Typical Low
$213.80
Median
$501.19
Typical High
$912.01
United
Setting
Professional
Modifier
Global
Typical Low
$331.13
Median
$512.86
Typical High
$691.83