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South Carolina 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 $501 · 10th–90th $316–$9550%10%20%10th90th$501Professionalmedian $389 · 10th–90th $302–$6030%10%10th90th$389$50.0$100.0$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
$302.00 / $380.19 / $537.03
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$398.11 / $724.44 / $831.76
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$562.34 / $562.34 / $616.60
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$407.38 / $407.38 / $912.01
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$363.08 / $363.08 / $363.08
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$316.23 / $537.03 / $1,148.15
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $213.80 / $218.78
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $478.63
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$436.52 / $501.19 / $912.01
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$275.42 / $354.81 / $501.19