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Maryland 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 $501 · 10th–90th $437–$5620%50%10th90th$501Professionalmedian $372 · 10th–90th $316–$6460%20%10th90th$372$200.0$500.0$1.0K$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$316.23 / $371.54 / $645.65
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$426.58 / $426.58 / $489.78
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$562.34 / $562.34 / $588.84
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$407.38 / $407.38 / $562.34
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$501.19 / $724.44 / $1,071.52
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$302.00 / $501.19 / $512.86
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$316.23 / $371.54 / $549.54
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$407.38 / $407.38 / $602.56