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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

Facilitymedian $562 · 10th–90th $309–$1,3180%20%10th90th$562Professionalmedian $501 · 10th–90th $309–$5500%20%40%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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$524.81 / $524.81 / $524.81
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$302.00 / $467.74 / $537.03
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$549.54 / $549.54 / $602.56
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 / $575.44
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$338.84 / $363.08 / $478.63
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$288.40 / $588.84 / $1,047.13
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.60 / $0.60 / $0.60
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$275.42 / $501.19 / $575.44
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$275.42 / $354.81 / $512.86
Wellcare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,548.13 / $3,548.13 / $3,548.13
Wellcare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,890.45 / $3,890.45 / $5,011.87