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Arizona rates for HCPCS L6890

Addition to upper extremity prosthesis, glove for terminal device, any material, prefabricated, includes fitting and adjustment

Facilitymedian $224 · 10th–90th $71–$5370%10%10th90th$224Professionalmedian $120 · 10th–90th $87–$2240%20%10th90th$120$0.2$1.0$5.0$20.0$100.0$500.0

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
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $120.23 / $199.53
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $154.88 / $154.88
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$70.79 / $295.12 / $549.54
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$208.93 / $269.15 / $524.81
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$169.82 / $169.82 / $169.82
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $123.03 / $169.82
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$66.07 / $181.97 / $1,148.15
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$91.20 / $102.33 / $1,318.26
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$107.15 / $158.49 / $223.87
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $102.33 / $154.88