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Nebraska rates for HCPCS L6915

Hand restoration (shading and measurements included), replacement glove for above

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$633.86 / $633.86 / $633.86
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$633.86 / $633.86 / $747.39
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$873.59 / $960.95 / $970.65
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$644.36 / $1,093.35 / $1,093.35
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$644.36 / $1,093.35 / $1,685.98
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$497.98 / $1,077.56 / $4,034.25
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$378.42 / $499.81 / $826.46
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,090.15 / $1,093.35 / $1,377.59
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$880.74 / $1,277.18 / $2,178.48
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$359.50 / $495.88 / $614.84