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Texas rates for HCPCS L6895

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

Facilitymedian $550 · 10th–90th $295$1,8620%10%20%10th90th$550Professionalmedian $339 · 10th–90th $295$5890%20%10th90th$339$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
$295.12 / $295.12 / $316.23
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$295.12 / $363.08 / $588.84
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,162.28 / $3,388.44 / $4,168.69
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$316.23 / $316.23 / $316.23
Christus
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$79.43 / $676.08 / $676.08
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 / $309.03 / $416.87
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,548.13 / $3,548.13 / $3,548.13
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,715.35 / $5,011.87 / $5,011.87
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$295.12 / $562.34 / $977.24
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$295.12 / $380.19 / $707.95
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$346.74 / $346.74 / $354.81
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$316.23 / $549.54 / $977.24
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$309.03 / $309.03 / $416.87
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$302.00 / $512.86 / $776.25
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$281.84 / $416.87 / $512.86
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$407.38 / $676.08 / $676.08