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Wyoming rates for HCPCS L7400

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$187.04 / $187.04 / $327.54
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$365.30 / $365.30 / $365.30
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$365.30 / $365.30 / $365.30
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$239.35 / $239.35 / $404.99
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$174.73 / $174.73 / $328.21
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$149.04 / $164.90 / $254.10