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Idaho rates for HCPCS L6895

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

Facilitymedian $676 · 10th–90th $398–$9330%20%10th90th$676Professionalmedian $537 · 10th–90th $324–$8320%10%10th90th$537$50.0$100.0$200.0$500.0$1.0K$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
$323.59 / $457.09 / $630.96
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$588.84 / $724.44 / $1,230.27
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$794.33 / $831.76 / $831.76
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$416.87 / $416.87 / $436.52
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$309.03 / $309.03 / $416.87
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$213.80 / $616.60 / $831.76
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$478.63 / $724.44 / $758.58
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $645.65
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$707.95 / $724.44 / $724.44
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$537.03 / $537.03 / $794.33
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$588.84 / $758.58 / $758.58
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$309.03 / $501.19 / $512.86
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$309.03 / $331.13 / $512.86