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Illinois rates for HCPCS L6895

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

Facilitymedian $912 · 10th–90th $398–$4,1690%20%10th90th$912Professionalmedian $398 · 10th–90th $309–$8130%20%10th90th$398$1.0$5.0$20.0$100.0$500.0$2.0K$10.0K

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 / $831.76
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$309.03 / $398.11 / $676.08
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$977.24 / $1,548.82 / $5,623.41
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$616.60 / $616.60 / $616.60
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
$309.03 / $309.03 / $851.14
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$602.56 / $691.83 / $933.25
Hally Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,047.13 / $1,047.13 / $1,047.13
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$457.09 / $457.09 / $645.65
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$446.68 / $660.69 / $1,096.48
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$302.00 / $398.11 / $676.08