Silicone gel socket insert for arm prosthesis

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

Elbow socket ins use w/o lck

Payers reporting HCPCS L6695

Payer pricing summary

Low

$207

Average

$857

Median

$787

High

$1.6k

Payer rate distribution

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#
1	Aetna fee schedule · outpatient · +12 other terms	361	$754	$868	$419	48%	—	$348 – $4.9k
2	UnitedHealthcare fee schedule · outpatient · +13 other terms	358	$749	$751	$183	24%	—	$333 – $2.4k
3	Humana fee schedule · outpatient · +11 other terms	319	$745	$1.1k	$1.2k	108%	—	$421 – $5.7k
4	Blue Cross Blue Shield fee schedule · outpatient · +11 other terms	219	$747	$1.0k	$551	55%	—	$0 – $3.6k
5	WellCare fee schedule · outpatient · +5 other terms	208	$770	$786	$104	13%	—	$668 – $1.3k
6	Devoted fee schedule · outpatient · +3 other terms	165	$747	$749	$20	3%	—	$725 – $927
7	Molina fee schedule · outpatient · +5 other terms	140	$1.1k	$1.0k	$390	38%	—	$455 – $2.0k
8	Cigna Healthspring fee schedule · outpatient · +2 other terms	116	$762	$757	$25	3%	—	$725 – $936
9	Cigna fee schedule · outpatient · +10 other terms	104	$760	$846	$244	29%	—	$438 – $2.4k
10	Anthem fee schedule · outpatient · +6 other terms	80	$758	$1.1k	$1.1k	101%	—	$528 – $6.0k
11	Kaiser fee schedule · outpatient · +5 other terms	64	$788	$1.2k	$844	69%	—	$731 – $5.4k
12	Ambetter facility · fee schedule · outpatient · +6 other terms	46	$1.1k	$1.3k	$318	24%	—	$585 – $1.8k
13	Superior Healthplan fee schedule · outpatient	40	$785	$784	$4	0%	—	$733 – $785
14	Clover fee schedule · outpatient · +3 other terms	37	$725	$726	$57	8%	—	$668 – $909
15	Oscar fee schedule · outpatient · +4 other terms	36	$762	$875	$216	25%	—	$732 – $1.4k
16	Optum fee schedule · outpatient · +3 other terms	33	$743	$982	$392	40%	—	$717 – $1.9k
17	Caresource fee schedule · outpatient · +5 other terms	29	$725	$797	$248	31%	—	$397 – $1.2k
18	Regence facility · fee schedule · outpatient · +4 other terms	19	$804	$767	$67	9%	—	$609 – $819
19	Amerihealth Caritas fee schedule · outpatient	18	$870	$848	$44	5%	—	$731 – $870
20	Bcbs Tx fee schedule · outpatient	18	$733	$733	—	—	—	$733 – $733
21	Medicare fee schedule · outpatient · +3 other terms	18	$743	$745	$6	1%	—	$743 – $758
22	Tricare facility · fee schedule · outpatient · +2 other terms	16	$717	$707	$32	5%	—	$614 – $758
23	Medical Mutual facility · fee schedule · outpatient · +2 other terms	15	$806	$927	$230	25%	—	$439 – $1.3k
24	Highmark facility · fee schedule · outpatient · +4 other terms	14	$1.2k	$1.2k	$498	42%	—	$682 – $2.0k
25	Bcbs Mn fee schedule · outpatient · +4 other terms	13	$734	$733	$171	23%	—	$357 – $859

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