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Vermont rates for HCPCS L6895

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

Facilitymedian $417 · 10th–90th $309–$6610%20%10th90th$417Professionalmedian $437 · 10th–90th $324–$5010%20%40%10th90th$437$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$323.59 / $436.52 / $501.19
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
MVP Health Care
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$691.83 / $691.83 / $870.96
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$309.03 / $338.84 / $524.81
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$323.59 / $549.54 / $1,778.28