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Upper Extremity Socket Insert, without Locking Mechanism

Utah 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

Rates data updated July 2026.

Facilitymedian $437 · 10th–90th $214$7590%20%40%10th90th$437Professionalmedian $437 · 10th–90th $214$3,3880%10%10th90th$437$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
Setting
Facility
Modifier
Global
Typical Low
$213.80
Median
$213.80
Typical High
$213.80
Aetna
Setting
Professional
Modifier
Global
Typical Low
$213.80
Median
$323.59
Typical High
$3,388.44
Cigna
Setting
Facility
Modifier
Global
Typical Low
$562.34
Median
$562.34
Typical High
$562.34
Cigna
Setting
Professional
Modifier
Global
Typical Low
$407.38
Median
$407.38
Typical High
$562.34
Molina
Setting
Professional
Modifier
Global
Typical Low
$60.26
Median
$549.54
Typical High
$707.95
Regence BlueShield
Setting
Facility
Modifier
Global
Typical Low
$724.44
Median
$758.58
Typical High
$758.58
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$416.87
Median
$537.03
Typical High
$812.83
Select Health
Setting
Facility
Modifier
Global
Typical Low
$776.25
Median
$776.25
Typical High
$776.25
Select Health
Setting
Professional
Modifier
Global
Typical Low
$389.05
Median
$741.31
Typical High
$776.25
U of Utah Health Plan
Setting
Professional
Modifier
Global
Typical Low
$537.03
Median
$776.25
Typical High
$870.96
United
Setting
Facility
Modifier
Global
Typical Low
$275.42
Median
$446.68
Typical High
$524.81
United
Setting
Professional
Modifier
Global
Typical Low
$263.03
Median
$331.13
Typical High
$512.86