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Maine 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 $933 · 10th–90th $562–$1,0720%20%40%10th90th$933Professionalmedian $427 · 10th–90th $324–$8130%10%20%10th90th$427$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 / $389.05 / $1,202.26
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$776.25 / $933.25 / $1,071.52
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$426.58 / $426.58 / $812.83
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 / $562.34
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$691.83 / $691.83 / $831.76
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$316.23 / $416.87 / $537.03
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$213.80 / $436.52 / $436.52
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$275.42 / $676.08 / $691.83