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Arizona rates for HCPCS L6895

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

Facilitymedian $550 · 10th–90th $204–$1,4130%10%10th90th$550Professionalmedian $398 · 10th–90th $295–$6760%20%10th90th$398$1.0$5.0$20.0$100.0$500.0$2.0K

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
Professional
Modifier
Typical Low / Median / Typical High
$295.12 / $398.11 / $660.69
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$177.83 / $724.44 / $1,380.38
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$512.86 / $660.69 / $1,288.25
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$416.87 / $416.87 / $416.87
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$309.03 / $309.03 / $416.87
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$213.80 / $478.63 / $3,467.37
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$302.00 / $331.13 / $3,715.35
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$309.03 / $512.86 / $549.54
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$263.03 / $331.13 / $501.19