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Montana rates for HCPCS L7400

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

Facilitymedian $363 · 10th–90th $245–$5370%20%40%10th90th$363Professionalmedian $234 · 10th–90th $117–$4270%10%10th90th$234$100.0$200.0$500.0$1.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$117.49 / $218.78 / $323.59
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$363.08 / $363.08 / $363.08
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$239.88 / $389.05 / $389.05
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$239.88 / $389.05 / $389.05
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$288.40 / $363.08 / $707.95
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$288.40 / $363.08 / $707.95
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$173.78 / $346.74 / $537.03
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $295.12 / $389.05
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$218.78 / $251.19 / $263.03
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $165.96 / $257.04