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Washington rates for HCPCS L6895

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

Facilitymedian $741 · 10th–90th $479–$1,7780%20%10th90th$741Professionalmedian $501 · 10th–90th $309–$1,0720%10%20%10th90th$501$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
$478.63 / $478.63 / $1,148.15
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$302.00 / $398.11 / $676.08
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$645.65 / $724.44 / $724.44
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$645.65 / $645.65 / $831.76
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
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$426.58 / $954.99 / $2,089.30
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$426.58 / $870.96 / $1,548.82
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $575.44 / $630.96
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$588.84 / $724.44 / $741.31
Pacific Source
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$676.08 / $691.83 / $741.31
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$645.65 / $1,096.48 / $1,479.11
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$616.60 / $616.60 / $724.44
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$724.44 / $724.44 / $724.44
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$645.65 / $645.65 / $831.76
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$446.68 / $912.01 / $1,096.48
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$316.23 / $446.68 / $630.96
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$446.68 / $537.03 / $1,148.15