go back

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

Facilitymedian $776 · 10th–90th $447–$3,4670%10%20%10th90th$776Professionalmedian $479 · 10th–90th $269–$1,9950%10%10th90th$479$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
$478.63 / $478.63 / $478.63
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $478.63 / $3,388.44
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$660.69 / $724.44 / $724.44
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$562.34 / $562.34 / $831.76
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$562.34 / $912.01 / $1,288.25
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$478.63 / $812.83 / $3,467.37
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$251.19 / $436.52 / $724.44
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$812.83 / $831.76 / $1,995.26
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$831.76 / $831.76 / $831.76
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,047.13 / $1,862.09 / $1,995.26
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$436.52 / $512.86 / $776.25
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $371.54 / $588.84