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Oklahoma 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 $417 · 10th–90th $316–$1,0720%20%10th90th$417Professionalmedian $372 · 10th–90th $309–$5620%20%10th90th$372$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
$316.23 / $316.23 / $316.23
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$316.23 / $371.54 / $562.34
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$645.65 / $645.65 / $645.65
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
$407.38 / $407.38 / $812.83
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$316.23 / $478.63 / $2,290.87
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$223.87 / $371.54 / $891.25
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$302.00 / $501.19 / $776.25
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$223.87 / $331.13 / $501.19