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Maryland rates for HCPCS L6895

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

Facilitymedian $501 · 10th–90th $309–$5130%20%40%10th90th$501Professionalmedian $398 · 10th–90th $302–$6310%10%20%10th90th$398$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
$295.12 / $398.11 / $630.96
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$398.11 / $398.11 / $524.81
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
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$524.81 / $758.58 / $1,148.15
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$302.00 / $501.19 / $512.86
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$331.13 / $389.05 / $588.84
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$407.38 / $407.38 / $645.65