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Tennessee 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 $562 · 10th–90th $302–$3,5480%20%10th90th$562Professionalmedian $355 · 10th–90th $302–$6030%20%10th90th$355$1.0$5.0$20.0$100.0$500.0$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
$302.00 / $302.00 / $537.03
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$302.00 / $346.74 / $602.56
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$549.54 / $549.54 / $575.44
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$562.34 / $562.34 / $645.65
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$407.38 / $407.38 / $562.34
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,548.13 / $3,548.13 / $3,548.13
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,890.45 / $5,011.87 / $5,011.87
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$398.11 / $501.19 / $524.81
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$234.42 / $346.74 / $501.19