Custom-made glove for prosthetic arm hand

Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.

Model: claude-haiku-5-5
Provider: anthropic
API: message_batches
Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

Custom glove for term device

Payers reporting HCPCS L6895

Payer pricing summary

Low

$177

Average

$875

Median

$783

High

$1.9k

Payer rate distribution

Filter by billing methodology

Filter by billing class

#
1	Aetna fee schedule · outpatient · +11 other terms	359	$766	$862	$415	48%	—	$367 – $5.1k
2	UnitedHealthcare fee schedule · outpatient · +12 other terms	356	$765	$740	$208	28%	—	$272 – $2.5k
3	Humana fee schedule · outpatient · +12 other terms	317	$758	$1.1k	$1.1k	101%	—	$430 – $5.3k
4	Blue Cross Blue Shield fee schedule · outpatient · +10 other terms	219	$781	$975	$542	56%	—	$0 – $3.5k
5	WellCare fee schedule · outpatient · +5 other terms	208	$751	$756	$118	16%	—	$670 – $1.3k
6	Devoted fee schedule · outpatient · +3 other terms	165	$724	$711	$44	6%	—	$671 – $929
7	Molina fee schedule · outpatient · +4 other terms	138	$1.0k	$978	$360	37%	—	$499 – $1.8k
8	Cigna Healthspring fee schedule · outpatient · +2 other terms	116	$788	$724	$61	8%	—	$684 – $938
9	Cigna fee schedule · outpatient · +10 other terms	102	$789	$858	$262	31%	—	$670 – $2.4k
10	Anthem fee schedule · outpatient · +8 other terms	80	$743	$1.1k	$1.1k	104%	—	$471 – $6.2k
11	Kaiser fee schedule · outpatient · +5 other terms	64	$713	$1.2k	$894	75%	—	$671 – $5.6k
12	Ambetter facility · fee schedule · outpatient · +6 other terms	46	$1.2k	$1.4k	$354	26%	—	$751 – $1.9k
13	Superior Healthplan fee schedule · outpatient	40	$718	$718	$3	0%	—	$670 – $718
14	Clover fee schedule · outpatient · +3 other terms	37	$718	$727	$62	8%	—	$670 – $911
15	Oscar fee schedule · outpatient · +6 other terms	36	$804	$838	$191	23%	—	$670 – $1.3k
16	Optum fee schedule · outpatient · +3 other terms	33	$766	$935	$339	36%	—	$671 – $1.7k
17	Caresource fee schedule · outpatient · +5 other terms	29	$766	$819	$258	32%	—	$419 – $1.3k
18	Regence facility · fee schedule · outpatient · +3 other terms	19	$727	$719	$27	4%	—	$633 – $741
19	Amerihealth Caritas fee schedule · outpatient · +1 other terms	18	$919	$895	$46	5%	—	$773 – $919
20	Bcbs Tx fee schedule · outpatient	18	$670	$670	—	—	—	$670 – $670
21	Medicare fee schedule · outpatient · +3 other terms	18	$671	$674	$5	1%	—	$671 – $685
22	Tricare facility · fee schedule · outpatient · +2 other terms	16	$747	$724	$43	6%	—	$615 – $758
23	Medical Mutual facility · fee schedule · outpatient · +1 other terms	15	$822	$945	$234	25%	—	$448 – $1.3k
24	Highmark facility · fee schedule · outpatient · +4 other terms	14	$1.2k	$1.3k	$524	42%	—	$684 – $2.2k
25	Bcbs Mn fee schedule · outpatient · +4 other terms	13	$748	$748	$175	23%	—	$364 – $876

Page 1 of 3 · 53 payers