HCPCS L6895
Addition to upper extremity prosthesis, glove for terminal device, any material, custom fabricated
Current code23 hospitals with prices
What Washington hospitals publish for this code
Commercial insurance: Rate negotiated with a private insurer or employer plan, including exchange and public-option plans.
| Hospital | Commercial insurance rates (lowest – highest) | Cash price | List price (before discounts) |
|---|---|---|---|
| Capital Medical Center | $654 – $5,075 | — | — |
| Deaconess Medical Center | $908 – $3,159 | — | — |
| Harborview Medical Center | $1,214 – $1,518 | $930 | $1,328 |
| Kadlec Regional Medical Center | $1,145 – $2,132 | — | — |
| Mary Bridge Children's Hospital | $654 – $5,571 | — | — |
| MultiCare Auburn Medical Center | $636 – $3,279 | — | — |
| MultiCare Covington Medical Center | $636 – $3,279 | — | — |
| MultiCare Good Samaritan Hospital | $738 – $3,279 | — | — |
| MultiCare Valley Hospital | $727 – $3,152 | — | — |
| Overlake Hospital Medical Center & Clinics | $696 – $2,088 | — | — |
| Prov Sacred HRT Med Ctr & Childs Hosp. | $1,176 – $2,518 | — | — |
| Providence Centralia Hospital | $1,283 – $2,838 | — | — |
| Providence Regional Medical Center Everett | $911 – $1,761 | — | — |
| Providence St Peter Hospital | $645 – $2,478 | — | — |
| Swedish Edmonds Hospital | $1,139 – $2,784 | — | — |
| Swedish Issaquah | $1,139 – $1,685 | — | — |
| Swedish Medical Center | $1,139 – $2,711 | — | — |
| Swedish Medical Center / Cherry Hill | $1,139 – $2,711 | — | — |
| Tacoma General Allenmore Hospital | $636 – $3,279 | — | — |
| University of Washington Medical Ctr | $1,214 – $2,380 | $1,172 | $1,675 |
| Virginia Mason Medical Center | $727 – $2,640 | — | — |
| Wellfound Behavioral Health Hospital | $1,915 | — | — |
| Yakima Valley Memorial | $654 – $1,969 | — | — |
Medicare (traditional) reference
Only for people on original Medicare. These are CMS’s 2026 amounts. They aren’t what private insurance or cash patients pay.
- Equipment fee, Washington
- $759 (fee)