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Utah rates for HCPCS L6890

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

Facilitymedian $135 · 10th–90th $65–$2190%20%40%10th90th$135Professionalmedian $158 · 10th–90th $65–$1,1750%5%10%10th90th$158$50.0$100.0$200.0$500.0$1.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$64.57 / $64.57 / $64.57
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $123.03 / $1,174.90
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$169.82 / $169.82 / $169.82
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $123.03 / $169.82
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $158.49 / $208.93
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$208.93 / $218.78 / $218.78
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $154.88 / $245.47
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$218.78 / $218.78 / $229.09
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $223.87 / $275.42
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$85.11 / $134.90 / $154.88
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $102.33 / $173.78