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Wyoming rates for HCPCS L6895

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$338.84 / $389.05 / $676.08
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$676.08 / $676.08 / $676.08
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$676.08 / $676.08 / $676.08
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$416.87 / $416.87 / $870.96
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$309.03 / $309.03 / $660.69
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$251.19 / $446.68 / $549.54
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$302.00 / $331.13 / $512.86