Prosthetic arm addition: silicone gel liner

Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.

Model: claude-haiku-5-5
Provider: anthropic
API: message_batches
Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

Silicone gel insert or equal

Payers reporting HCPCS L6692

Payer pricing summary

Low

$237

Average

$900

Median

$854

High

$1.9k

Payer rate distribution

Filter by billing methodology

Filter by billing class

#
1	Aetna fee schedule · outpatient · +12 other terms	361	$811	$883	$424	48%	—	$328 – $5.5k
2	UnitedHealthcare fee schedule · outpatient · +14 other terms	358	$760	$748	$195	26%	—	$252 – $2.3k
3	Humana fee schedule · outpatient · +12 other terms	319	$747	$1.2k	$1.4k	119%	—	$411 – $6.7k
4	Blue Cross Blue Shield fee schedule · outpatient · +10 other terms	220	$854	$1.0k	$574	56%	—	$0 – $4.2k
5	WellCare fee schedule · outpatient · +4 other terms	208	$854	$853	$128	15%	—	$671 – $1.4k
6	Devoted fee schedule · outpatient · +3 other terms	165	$840	$826	$79	10%	—	$685 – $932
7	Molina fee schedule · outpatient · +5 other terms	140	$1.2k	$1.2k	$462	40%	—	$435 – $2.3k
8	Cigna Healthspring fee schedule · outpatient · +1 other terms	116	$733	$830	$69	8%	—	$685 – $940
9	Cigna fee schedule · outpatient · +8 other terms	102	$839	$854	$238	28%	—	$671 – $2.3k
10	Anthem fee schedule · outpatient · +7 other terms	80	$840	$1.1k	$1.0k	97%	—	$411 – $5.9k
11	Kaiser fee schedule · outpatient · +6 other terms	64	$874	$1.2k	$779	62%	—	$685 – $5.0k
12	Superior Healthplan fee schedule · outpatient	40	$915	$914	$4	0%	—	$854 – $915
13	Clover fee schedule · outpatient · +2 other terms	37	$694	$744	$93	13%	—	$681 – $915
14	Ambetter facility · fee schedule · outpatient · +6 other terms	36	$1.4k	$1.4k	$265	19%	—	$571 – $1.7k
15	Oscar fee schedule · outpatient · +6 other terms	36	$854	$937	$255	27%	—	$719 – $1.6k
16	Optum fee schedule · outpatient · +2 other terms	33	$823	$1.1k	$508	48%	—	$679 – $2.2k
17	Caresource fee schedule · outpatient · +5 other terms	29	$685	$753	$263	35%	—	$374 – $1.2k
18	Regence facility · fee schedule · outpatient · +4 other terms	19	$891	$817	$124	15%	—	$571 – $908
19	Amerihealth Caritas fee schedule · outpatient · +1 other terms	18	$822	$801	$39	5%	—	$698 – $822
20	Bcbs Tx fee schedule · outpatient	18	$854	$854	—	—	—	$854 – $854
21	Medicare fee schedule · outpatient · +3 other terms	18	$823	$826	$6	1%	—	$823 – $840
22	Medical Mutual facility · fee schedule · outpatient · +2 other terms	15	$788	$907	$224	25%	—	$429 – $1.2k
23	Bcbs Mn fee schedule · outpatient · +4 other terms	13	$716	$716	$167	23%	—	$349 – $839
24	Wellmark fee schedule · both · +4 other terms	13	$666	$663	$15	2%	—	$573 – $666
25	Aetna Better Health fee schedule · outpatient · +3 other terms	12	$424	$527	$122	23%	—	$424 – $671

Page 1 of 3 · 53 payers