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Indiana rates for HCPCS L6895

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

Facilitymedian $832 · 10th–90th $380–$9330%20%40%10th90th$832Professionalmedian $398 · 10th–90th $316–$6610%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
Facility
Modifier
Typical Low / Median / Typical High
$380.19 / $380.19 / $380.19
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$316.23 / $389.05 / $602.56
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$446.68 / $831.76 / $1,023.29
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$398.11 / $446.68 / $812.83
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$758.58 / $977.24 / $1,122.02
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$416.87 / $416.87 / $831.76
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$309.03 / $309.03 / $707.95
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$446.68 / $512.86 / $660.69
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$223.87 / $398.11 / $575.44