go back

Maryland 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
Professional
Modifier
Low / Median / High Price
$154.97 / $177.08 / $288.74
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$219.70 / $219.70 / $219.70
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 / $174.73
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$252.79 / $361.13 / $520.03
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$162.66 / $189.18 / $285.70
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$200.01 / $200.01 / $252.79