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Indiana rates for HCPCS L6890

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

Facilitymedian $245 · 10th–90th $115–$2630%50%10th90th$245Professionalmedian $120 · 10th–90th $95–$2000%50%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
Facility
Modifier
Typical Low / Median / Typical High
$114.82 / $114.82 / $114.82
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $114.82 / $177.83
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$123.03 / $245.47 / $309.03
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $123.03 / $223.87
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$204.17 / $263.03 / $309.03
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$165.96 / $169.82 / $245.47
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $123.03 / $208.93
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$134.90 / $154.88 / $194.98
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$67.61 / $120.23 / $181.97