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North Carolina rates for HCPCS L6895

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

Facilitymedian $562 · 10th–90th $324–$1,3490%20%10th90th$562Professionalmedian $513 · 10th–90th $316–$5750%20%40%10th90th$513$1.0$10.0$100.0$1.0K$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
$562.34 / $562.34 / $562.34
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$316.23 / $478.63 / $575.44
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$616.60 / $616.60 / $741.31
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$575.44 / $575.44 / $630.96
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$331.13 / $416.87 / $467.74
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$309.03 / $309.03 / $512.86
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$309.03 / $338.84 / $501.19
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$309.03 / $616.60 / $1,071.52
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$309.03 / $501.19 / $616.60
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$295.12 / $371.54 / $524.81
Wellcare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,548.13 / $3,548.13 / $3,548.13
Wellcare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,715.35 / $3,715.35 / $5,011.87