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Hand Restoration, Replacement Glove

Vermont rates for HCPCS L6915

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

Rates data updated July 2026.

Facilitymedian $589 · 10th–90th $490$6460%20%40%10th90th$589Professionalmedian $457 · 10th–90th $398$6030%20%40%10th90th$457$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
Setting
Professional
Modifier
Global
Typical Low
$398.11
Median
$398.11
Typical High
$478.63
Cigna
Setting
Facility
Modifier
Global
Typical Low
$588.84
Median
$645.65
Typical High
$645.65
Cigna
Setting
Professional
Modifier
Global
Typical Low
$467.74
Median
$467.74
Typical High
$645.65
MVP Health Care
Setting
Professional
Modifier
Global
Typical Low
$630.96
Median
$630.96
Typical High
$794.33
United
Setting
Facility
Modifier
Global
Typical Low
$489.78
Median
$562.34
Typical High
$588.84
United
Setting
Professional
Modifier
Global
Typical Low
$288.40
Median
$575.44
Typical High
$1,621.81