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Upper Extremity Socket Insert, without Locking Mechanism

Nebraska 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 $759 · 10th–90th $479$1,6220%20%10th90th$759Professionalmedian $324 · 10th–90th $263$5620%20%40%10th90th$324$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
Setting
Facility
Modifier
Global
Typical Low
$478.63
Median
$478.63
Typical High
$478.63
Aetna
Setting
Professional
Modifier
Global
Typical Low
$263.03
Median
$323.59
Typical High
$478.63
BCBS
Setting
Professional
Modifier
Global
Typical Low
$660.69
Median
$724.44
Typical High
$724.44
Cigna
Setting
Facility
Modifier
Global
Typical Low
$562.34
Median
$562.34
Typical High
$831.76
Cigna
Setting
Professional
Modifier
Global
Typical Low
$562.34
Median
$912.01
Typical High
$1,584.89
Medica
Setting
Facility
Modifier
Global
Typical Low
$478.63
Median
$812.83
Typical High
$3,467.37
Medica
Setting
Professional
Modifier
Global
Typical Low
$251.19
Median
$436.52
Typical High
$724.44
Midlands
Setting
Professional
Modifier
Global
Typical Low
$812.83
Median
$831.76
Typical High
$1,995.26
Midlands
Setting
Facility
Modifier
Global
Typical Low
$831.76
Median
$831.76
Typical High
$831.76
Midlands
Setting
Professional
Modifier
Global
Typical Low
$1,047.13
Median
$1,862.09
Typical High
$1,995.26
United
Setting
Facility
Modifier
Global
Typical Low
$436.52
Median
$758.58
Typical High
$776.25
United
Setting
Professional
Modifier
Global
Typical Low
$269.15
Median
$398.11
Typical High
$588.84