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New Hampshire rates for HCPCS L6895

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

Facilitymedian $912 · 10th–90th $501–$1,0720%20%40%10th90th$912Professionalmedian $603 · 10th–90th $347–$8130%20%10th90th$603$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
Facility
Modifier
Typical Low / Median / Typical High
$501.19 / $501.19 / $602.56
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$288.40 / $436.52 / $630.96
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$912.01 / $977.24 / $1,122.02
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$446.68 / $446.68 / $457.09
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$416.87 / $416.87 / $660.69
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$309.03 / $309.03 / $416.87
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$776.25 / $776.25 / $1,445.44
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$204.17 / $446.68 / $501.19
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$331.13 / $512.86 / $776.25
Well Sense
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$870.96 / $870.96 / $1,288.25