go back

Upper Extremity Socket Insert, without Locking Mechanism

Washington 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 $724 · 10th–90th $501$1,7780%10%20%10th90th$724Professionalmedian $589 · 10th–90th $380$1,3180%10%20%10th90th$589$10.0$50.0$200.0$1.0K$5.0K

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
$467.74
Median
$467.74
Typical High
$1,096.48
Aetna
Setting
Professional
Modifier
Global
Typical Low
$380.19
Median
$467.74
Typical High
$3,388.44
Asuris Northwest Health
Setting
Facility
Modifier
Global
Typical Low
$676.08
Median
$691.83
Typical High
$724.44
Asuris Northwest Health
Setting
Professional
Modifier
Global
Typical Low
$616.60
Median
$616.60
Typical High
$812.83
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
Kaiser Permanente
Setting
Facility
Modifier
Global
Typical Low
$467.74
Median
$1,000.00
Typical High
$2,041.74
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$446.68
Median
$831.76
Typical High
$1,548.82
Molina
Setting
Professional
Modifier
Global
Typical Low
$75.86
Median
$489.78
Typical High
$602.56
Pacific Source
Setting
Facility
Modifier
Global
Typical Low
$691.83
Median
$724.44
Typical High
$741.31
Premera BCBS
Setting
Facility
Modifier
Global
Typical Low
$630.96
Median
$1,047.13
Typical High
$1,445.44
Premera BCBS
Setting
Professional
Modifier
Global
Typical Low
$588.84
Median
$588.84
Typical High
$691.83
Regence BlueShield
Setting
Facility
Modifier
Global
Typical Low
$691.83
Median
$691.83
Typical High
$724.44
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$616.60
Median
$616.60
Typical High
$812.83
United
Setting
Facility
Modifier
Global
Typical Low
$436.52
Median
$1,096.48
Typical High
$1,096.48
United
Setting
Professional
Modifier
Global
Typical Low
$316.23
Median
$478.63
Typical High
$645.65
Wellpoint
Setting
Professional
Modifier
Global
Typical Low
$426.58
Median
$512.86
Typical High
$1,096.48