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California rates for HCPCS L6895

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

Facilitymedian $389 · 10th–90th $309–$1,7780%20%10th90th$389Professionalmedian $407 · 10th–90th $309–$2,5700%20%10th90th$407$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
Facility
Modifier
Typical Low / Median / Typical High
$398.11 / $398.11 / $2,884.03
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$309.03 / $398.11 / $2,570.40
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$309.03 / $389.05 / $1,659.59
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$398.11 / $446.68 / $977.24
Blue Shield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$407.38 / $977.24 / $1,584.89
Blue Shield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$645.65 / $1,230.27 / $2,511.89
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$316.23 / $416.87 / $416.87
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$309.03 / $309.03 / $416.87
Contra Costa Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $269.15 / $812.83
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$407.38 / $616.60 / $1,071.52
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,548.13 / $3,548.13 / $3,548.13
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,715.35 / $5,011.87 / $5,011.87
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$676.08 / $676.08 / $676.08
Optum
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $54.95 / $70.79
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$245.47 / $645.65 / $912.01
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$309.03 / $309.03 / $707.95
Sutter Health Plus
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,258.93 / $1,258.93 / $1,258.93
The Alliance
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $281.84 / $616.60
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$54.95 / $446.68 / $912.01
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$309.03 / $407.38 / $776.25