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Hand Restoration, Replacement Glove

Wisconsin rates for HCPCS L6915

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

Rates data updated July 2026.

Facilitymedian $1,000 · 10th–90th $776$1,8200%50%10th90th$1,000Professionalmedian $933 · 10th–90th $490$1,5850%20%10th90th$933$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
Setting
Facility
Modifier
Global
Typical Low
$489.78
Median
$489.78
Typical High
$489.78
Aetna
Setting
Professional
Modifier
Global
Typical Low
$489.78
Median
$489.78
Typical High
$912.01
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$1,000.00
Median
$1,000.00
Typical High
$1,659.59
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$933.25
Median
$933.25
Typical High
$1,122.02
Cigna
Setting
Facility
Modifier
Global
Typical Low
$645.65
Median
$2,290.87
Typical High
$5,128.61
Cigna
Setting
Professional
Modifier
Global
Typical Low
$467.74
Median
$1,445.44
Typical High
$1,905.46
DeanCare
Setting
Facility
Modifier
Global
Typical Low
$489.78
Median
$812.83
Typical High
$1,230.27
DeanCare
Setting
Professional
Modifier
Global
Typical Low
$562.34
Median
$977.24
Typical High
$1,202.26
Medica
Setting
Facility
Modifier
Global
Typical Low
$489.78
Median
$977.24
Typical High
$4,073.80
Medica
Setting
Professional
Modifier
Global
Typical Low
$436.52
Median
$562.34
Typical High
$1,096.48
Molina
Setting
Professional
Modifier
Global
Typical Low
$54.95
Median
$70.79
Typical High
$549.54
Network Health
Setting
Facility
Modifier
Global
Typical Low
$1,584.89
Median
$1,584.89
Typical High
$1,584.89
Network Health
Setting
Professional
Modifier
Global
Typical Low
$707.95
Median
$1,122.02
Typical High
$1,949.84
Prevea360
Setting
Facility
Modifier
Global
Typical Low
$489.78
Median
$812.83
Typical High
$1,230.27
Prevea360
Setting
Professional
Modifier
Global
Typical Low
$562.34
Median
$977.24
Typical High
$977.24
Quartz
Setting
Professional
Modifier
Global
Typical Low
$1,000.00
Median
$1,479.11
Typical High
$2,238.72
Quartz
Setting
Facility
Modifier
Global
Typical Low
$645.65
Median
$2,041.74
Typical High
$4,073.80
Quartz
Setting
Professional
Modifier
Global
Typical Low
$467.74
Median
$1,479.11
Typical High
$4,786.30
United
Setting
Facility
Modifier
Global
Typical Low
$489.78
Median
$562.34
Typical High
$1,000.00
United
Setting
Professional
Modifier
Global
Typical Low
$323.59
Median
$501.19
Typical High
$831.76