go back

North Dakota 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
$269.15 / $269.15 / $309.03
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$158.49 / $199.53 / $309.03
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$309.03 / $416.87 / $457.09
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$426.58 / $426.58 / $537.03
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$162.18 / $309.03 / $1,737.80
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$147.91 / $186.21 / $371.54
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$218.78 / $537.03 / $537.03
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$128.82 / $223.87 / $398.11