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Missouri rates for HCPCS L6895

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

Facilitymedian $631 · 10th–90th $355–$1,6220%20%10th90th$631Professionalmedian $427 · 10th–90th $295–$7240%20%10th90th$427$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
$346.74 / $512.86 / $512.86
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$288.40 / $398.11 / $724.44
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$776.25 / $776.25 / $2,754.23
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$398.11 / $446.68 / $724.44
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$467.74 / $467.74 / $776.25
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
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$371.54 / $616.60 / $1,737.80
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$263.03 / $389.05 / $3,715.35
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$446.68 / $630.96 / $630.96
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$281.84 / $380.19 / $549.54