go back

Iowa rates for HCPCS L6895

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

Facilitymedian $741 · 10th–90th $468–$1,9050%20%10th90th$741Professionalmedian $427 · 10th–90th $309–$7240%20%10th90th$427$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
$501.19 / $602.56 / $676.08
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$309.03 / $407.38 / $630.96
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$416.87 / $416.87 / $870.96
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$416.87 / $933.25 / $1,174.90
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$575.44 / $691.83 / $812.83
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$524.81 / $1,000.00 / $3,467.37
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$363.08 / $501.19 / $1,288.25
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$851.14 / $870.96 / $1,023.29
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$870.96 / $870.96 / $870.96
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$776.25 / $1,288.25 / $1,288.25
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$309.03 / $776.25 / $1,778.28
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$354.81 / $407.38 / $724.44
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$588.84 / $758.58 / $758.58