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Rhode Island 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
Professional
Modifier
Low / Median / High Price
$100.00 / $120.23 / $346.74
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$331.13 / $446.68 / $524.81
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$109.65 / $147.91 / $239.88
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$131.83 / $131.83 / $169.82
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$123.03 / $123.03 / $169.82
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$134.90 / $158.49 / $275.42
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$102.33 / $128.82 / $186.21