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Arkansas rates for HCPCS L6895

Addition to upper extremity prosthesis, glove for terminal device, any material, custom fabricated

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$371.54 / $426.58 / $426.58
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$295.12 / $354.81 / $602.56
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$218,776.16 / $524,807.46 / $954,992.59
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$575.44 / $575.44 / $758.58
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$416.87 / $416.87 / $549.54
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$281.84 / $309.03 / $416.87
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$309.03 / $776.25 / $912.01
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$223.87 / $331.13 / $512.86