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Massachusetts rates for HCPCS L7400

Addition To Upper Extremity Prosthesis Below Elbow Elbow/Wrist Disarticulation Ultralight Material (Titanium Carbon Fiber Or Equal)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$157.79 / $157.79 / $157.79
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$157.79 / $166.42 / $287.35
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$323.11 / $1,019.09 / $1,722.99
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$164.90 / $268.27 / $352.67
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$260.11 / $320.43 / $320.43
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$239.35 / $239.35 / $239.35
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$174.73 / $174.73 / $429.00
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$83.43 / $4,618.00 / $9,239.00
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$292.39 / $292.39 / $307.02
Health New England
Facility/Professional
Professional
Modifier
Low / Median / High Price
$274.97 / $274.97 / $274.97
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$751.08 / $1,722.99 / $1,722.99
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$141.07 / $193.03 / $352.67
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$141.07 / $193.03 / $352.67