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Nevada rates for HCPCS L6895

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$218.78 / $218.78 / $218.78
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$288.40 / $398.11 / $676.08
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$676.08 / $676.08 / $724.44
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$446.68 / $446.68 / $537.03
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$380.19 / $416.87 / $537.03
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$309.03 / $309.03 / $524.81
Hometown Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$380.19 / $676.08 / $1,202.26
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$602.56 / $676.08 / $691.83
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$251.19 / $338.84 / $501.19
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$309.03 / $478.63 / $676.08