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Nebraska 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
$234.79 / $234.79 / $234.79
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$234.79 / $234.79 / $276.83
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$323.58 / $355.94 / $359.54
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$239.35 / $404.99 / $404.99
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$393.95 / $429.00 / $624.51
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$185.37 / $399.14 / $1,722.99
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$140.16 / $217.90 / $306.13
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$403.80 / $404.99 / $510.28
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$361.00 / $478.62 / $834.35
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$140.16 / $183.68 / $254.10