go back

Oklahoma rates for HCPCS L6890

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$94.94 / $94.94 / $94.94
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$94.94 / $108.50 / $108.50
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.83 / $193.75 / $193.75
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$170.15 / $170.15 / $170.15
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$124.21 / $170.15 / $170.15
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$65.75 / $132.88 / $1,135.98
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.90 / $134.58 / $223.99
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.90 / $105.46 / $153.41