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Missouri rates for HCPCS L6890

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

Facilitymedian $224 · 10th–90th $123–$5130%20%10th90th$224Professionalmedian $129 · 10th–90th $93–$2570%20%10th90th$129$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
$123.03 / $181.97 / $181.97
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $123.03 / $257.04
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$275.42 / $275.42 / $977.24
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $128.82 / $257.04
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$165.96 / $165.96 / $275.42
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$169.82 / $169.82 / $177.83
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
$114.82 / $213.80 / $602.56
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$91.20 / $134.90 / $1,318.26
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$134.90 / $223.87 / $223.87
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$91.20 / $131.83 / $194.98