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Michigan rates for HCPCS L6895

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

Facilitymedian $912 · 10th–90th $447–$3,2360%20%10th90th$912Professionalmedian $427 · 10th–90th $295–$8130%20%10th90th$427$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
$457.09 / $457.09 / $457.09
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$295.12 / $398.11 / $562.34
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,071.52 / $2,454.71 / $4,677.35
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$812.83 / $812.83 / $851.14
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$489.78 / $489.78 / $489.78
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$416.87 / $416.87 / $416.87
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$309.03 / $416.87 / $831.76
Health Alliance Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$457.09 / $1,548.82 / $1,698.24
Health Alliance Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$389.05 / $645.65 / $977.24
Priority Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$416.87 / $416.87 / $416.87
Priority Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$309.03 / $524.81 / $758.58
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$446.68 / $660.69 / $912.01
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$281.84 / $380.19 / $537.03