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New York 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 $537 · 10th–90th $288–$1,2300%20%10th90th$537Professionalmedian $427 · 10th–90th $302–$9330%20%40%10th90th$427$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
$245.47 / $537.03 / $758.58
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$263.03 / $371.54 / $588.84
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$676.08 / $676.08 / $1,348.96
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$426.58 / $436.52 / $1,071.52
CDPHP
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$512.86 / $562.34 / $562.34
CDPHP
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$562.34 / $562.34 / $562.34
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$562.34 / $562.34 / $53,703.18
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$407.38 / $407.38 / $912.01
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$676.08 / $1,122.02 / $2,630.27
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$426.58 / $676.08 / $1,288.25
Excellus BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$457.09 / $457.09 / $478.63
Excellus BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$398.11 / $426.58 / $457.09
MVP Health Care
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$977.24 / $50,118.72 / $75,857.76
MVP Health Care
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$446.68 / $645.65 / $645.65
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$281.84 / $501.19 / $1,905.46
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$245.47 / $446.68 / $1,122.02
Univera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$380.19 / $398.11 / $478.63
Univera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$398.11 / $426.58 / $457.09