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Oregon 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 $692 · 10th–90th $537$7590%20%10th90th$692Professionalmedian $437 · 10th–90th $309$8130%10%20%10th90th$437$100.0$500.0$2.0K$10.0K$50.0K

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
$436.52 / $436.52 / $436.52
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$302.00 / $398.11 / $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 / $407.38
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$549.54 / $1,479.11 / $1,778.28
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$436.52 / $537.03 / $776.25
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$524.81 / $575.44 / $776.25
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$691.83 / $724.44 / $741.31
Pacific Source
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$512.86 / $512.86 / $512.86
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$380.19 / $602.56 / $831.76
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $630.96 / $758.58
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$602.56 / $1,148.15 / $2,818.38
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$724.44 / $812.83 / $812.83
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$257.04 / $512.86 / $1,096.48
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$275.42 / $331.13 / $630.96