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South Dakota rates for HCPCS L7400

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

Facilitymedian $309 · 10th–90th $275–$6170%20%40%10th90th$309Professionalmedian $309 · 10th–90th $162–$5010%20%10th90th$309$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$269.15 / $309.03 / $309.03
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $302.00 / $363.08
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$239.88 / $239.88 / $416.87
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$426.58 / $426.58 / $537.03
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$295.12 / $380.19 / $1,000.00
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $251.19 / $1,862.09
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$338.84 / $407.38 / $407.38
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$416.87 / $416.87 / $416.87
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$338.84 / $338.84 / $676.08
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$309.03 / $371.54 / $489.78
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$128.82 / $251.19 / $436.52
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$363.08 / $363.08 / $363.08