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Virginia rates for HCPCS L6895

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

Facilitymedian $759 · 10th–90th $389–$9550%20%40%10th90th$759Professionalmedian $427 · 10th–90th $316–$7240%20%10th90th$427$1.0$5.0$20.0$100.0$500.0$2.0K$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
$389.05 / $398.11 / $398.11
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$295.12 / $389.05 / $602.56
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$758.58 / $758.58 / $812.83
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$446.68 / $446.68 / $933.25
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$398.11 / $398.11 / $524.81
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$338.84 / $416.87 / $416.87
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$309.03 / $309.03 / $416.87
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$562.34 / $758.58 / $1,071.52
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$338.84 / $501.19 / $741.31
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$316.23 / $524.81 / $891.25
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$398.11 / $407.38 / $489.78
Sentara
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$426.58 / $616.60 / $1,621.81
Sentara
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$426.58 / $616.60 / $1,621.81
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$257.04 / $501.19 / $758.58
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$338.84 / $371.54 / $588.84