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Alaska rates for HCPCS L7401

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

Facilitymedian $224 · 10th–90th $120–$4170%20%40%10th90th$224Professionalmedian $269 · 10th–90th $200–$5010%10%20%10th90th$269$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$194.98 / $263.03 / $363.08
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$269.15 / $269.15 / $269.15
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$194.98 / $194.98 / $446.68
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$120.23 / $263.03 / $398.11
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$223.87 / $389.05 / $1,318.26
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$354.81 / $398.11 / $416.87
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$323.59 / $398.11 / $416.87
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$120.23 / $120.23 / $416.87
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $269.15 / $389.05
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$245.47 / $245.47 / $275.42
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$194.98 / $199.53 / $891.25