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Wisconsin rates for HCPCS L7400

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

Facilitymedian $380 · 10th–90th $339–$6920%20%40%10th90th$380Professionalmedian $269 · 10th–90th $162–$5620%20%10th90th$269$0.5$2.0$10.0$50.0$200.0$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$186.21 / $186.21 / $186.21
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$158.49 / $186.21 / $309.03
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$380.19 / $380.19 / $616.60
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$281.84 / $354.81 / $426.58
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$239.88 / $870.96 / $1,862.09
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$173.78 / $537.03 / $707.95
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$186.21 / $302.00 / $467.74
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$338.84 / $446.68 / $562.34
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$186.21 / $371.54 / $1,737.80
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$169.82 / $234.42 / $416.87
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $70.79 / $234.42
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$602.56 / $602.56 / $602.56
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $426.58 / $741.31
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$380.19 / $562.34 / $1,047.13
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$239.88 / $758.58 / $1,737.80
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$173.78 / $346.74 / $1,862.09
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$194.98 / $251.19 / $380.19
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$144.54 / $186.21 / $309.03