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Utah rates for HCPCS L7400

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

Facilitymedian $240 · 10th–90th $107–$3720%20%40%10th90th$240Professionalmedian $269 · 10th–90th $107–$1,5850%10%10th90th$269$50.0$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
$107.15 / $107.15 / $107.15
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $199.53 / $1,584.89
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$239.88 / $239.88 / $239.88
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$173.78 / $173.78 / $239.88
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $275.42 / $346.74
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$354.81 / $371.54 / $371.54
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$257.04 / $269.15 / $407.38
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$363.08 / $371.54 / $380.19
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $380.19 / $446.68
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$138.04 / $218.78 / $251.19
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$128.82 / $165.96 / $275.42