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Iowa rates for HCPCS L6890

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

Facilitymedian $263 · 10th–90th $158–$6170%10%20%10th90th$263Professionalmedian $135 · 10th–90th $87–$2690%10%20%10th90th$135$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
Facility
Modifier
Typical Low / Median / Typical High
$158.49 / $213.80 / $213.80
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $120.23 / $204.17
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$169.82 / $169.82 / $302.00
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$169.82 / $281.84 / $346.74
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$218.78 / $295.12 / $346.74
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$186.21 / $323.59 / $1,148.15
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $158.49 / $457.09
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$302.00 / $309.03 / $354.81
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$302.00 / $302.00 / $302.00
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$234.42 / $457.09 / $457.09
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $275.42 / $537.03
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $134.90 / $245.47
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$208.93 / $269.15 / $269.15