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Mississippi rates for HCPCS L7400

Addition to upper extremity prosthesis, below elbow/wrist disarticulation, ultra-light material (titanium, carbon fiber or equal)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$208.93 / $208.93 / $323.59
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$162.18 / $194.98 / $309.03
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$302.00 / $302.00 / $302.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$288.40 / $288.40 / $288.40
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$288.40 / $288.40 / $288.40
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$239.88 / $239.88 / $239.88
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$173.78 / $173.78 / $239.88
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$218.78 / $295.12 / $446.68
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$109.65 / $177.83 / $257.04