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Wyoming 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 $513 · 10th–90th $437–$7410%20%10th90th$513Professionalmedian $603 · 10th–90th $380–$7410%20%10th90th$603$200.0$500.0$1.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$380.19 / $524.81 / $660.69
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$741.31 / $741.31 / $741.31
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$741.31 / $741.31 / $741.31
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 / $562.34
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$251.19 / $446.68 / $512.86
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$302.00 / $331.13 / $512.86