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New Jersey 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 $251 · 10th–90th $245–$6760%20%40%10th90th$251Professionalmedian $389 · 10th–90th $263–$6610%10%10th90th$389$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$245.47 / $245.47 / $245.47
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$263.03 / $346.74 / $616.60
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$562.34 / $562.34 / $676.08
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$407.38 / $407.38 / $562.34
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$446.68 / $645.65 / $912.01
Horizon BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$660.69 / $660.69 / $660.69
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$436.52 / $501.19 / $776.25
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$309.03 / $398.11 / $660.69