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Upper Extremity Socket Insert, without Locking Mechanism

North Carolina 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

Rates data updated July 2026.

Facilitymedian $562 · 10th–90th $324$1,2590%20%10th90th$562Professionalmedian $525 · 10th–90th $316$5500%50%10th90th$525$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
$524.81
Median
$524.81
Typical High
$524.81
Aetna
Setting
Professional
Modifier
Global
Typical Low
$302.00
Median
$524.81
Typical High
$524.81
BCBS
Setting
Facility
Modifier
Global
Typical Low
$588.84
Median
$707.95
Typical High
$1,412.54
BCBS
Setting
Professional
Modifier
Global
Typical Low
$549.54
Median
$549.54
Typical High
$602.56
Cigna
Setting
Facility
Modifier
Global
Typical Low
$562.34
Median
$562.34
Typical High
$588.84
Cigna
Setting
Professional
Modifier
Global
Typical Low
$407.38
Median
$407.38
Typical High
$575.44
Medcost
Setting
Professional
Modifier
Global
Typical Low
$338.84
Median
$363.08
Typical High
$478.63
Medcost
Setting
Facility
Modifier
Global
Typical Low
$288.40
Median
$588.84
Typical High
$1,047.13
United
Setting
Facility
Modifier
Global
Typical Low
$436.52
Median
$575.44
Typical High
$724.44
United
Setting
Professional
Modifier
Global
Typical Low
$275.42
Median
$354.81
Typical High
$512.86
Wellcare
Setting
Facility
Modifier
Global
Typical Low
$3,548.13
Median
$3,548.13
Typical High
$3,548.13
Wellcare
Setting
Professional
Modifier
Global
Typical Low
$3,890.45
Median
$3,890.45
Typical High
$5,011.87