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North Dakota 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 $550 · 10th–90th $550–$1,1480%20%40%90th$550Professionalmedian $646 · 10th–90th $324–$9120%10%20%10th90th$646$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$549.54 / $549.54 / $660.69
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$323.59 / $398.11 / $741.31
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$630.96 / $831.76 / $912.01
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
$562.34 / $912.01 / $1,148.15
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$323.59 / $660.69 / $1,659.59
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$302.00 / $380.19 / $758.58
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$436.52 / $436.52 / $1,096.48
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$275.42 / $512.86 / $933.25