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Washington rates for HCPCS L7400

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

Facilitymedian $372 · 10th–90th $234–$8710%20%10th90th$372Professionalmedian $257 · 10th–90th $162–$5370%20%10th90th$257$1.0$5.0$20.0$100.0$500.0$2.0K

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
Facility
Modifier
Typical Low / Median / Typical High
$234.42 / $234.42 / $562.34
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$158.49 / $199.53 / $323.59
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$316.23 / $354.81 / $354.81
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$316.23 / $316.23 / $407.38
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
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$208.93 / $489.78 / $1,023.29
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$208.93 / $426.58 / $758.58
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $275.42 / $302.00
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$354.81 / $363.08 / $363.08
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$316.23 / $524.81 / $724.44
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$302.00 / $302.00 / $354.81
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$354.81 / $354.81 / $354.81
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$316.23 / $316.23 / $407.38
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$218.78 / $537.03 / $537.03
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $218.78 / $316.23
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$223.87 / $257.04 / $549.54