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Above Elbow Disarticulation, Ultra-Light Material

Alaska rates for HCPCS L7401

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

Rates data updated July 2026.

Facilitymedian $120 · 10th–90th $120$4170%20%40%90th$120Professionalmedian $275 · 10th–90th $195$5010%10%20%10th90th$275$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
Setting
Professional
Modifier
Global
Typical Low
$194.98
Median
$223.87
Typical High
$354.81
Cigna
Setting
Facility
Modifier
Global
Typical Low
$269.15
Median
$269.15
Typical High
$269.15
Cigna
Setting
Professional
Modifier
Global
Typical Low
$194.98
Median
$194.98
Typical High
$446.68
Moda Health
Setting
Facility
Modifier
Global
Typical Low
$120.23
Median
$251.19
Typical High
$416.87
Moda Health
Setting
Professional
Modifier
Global
Typical Low
$389.05
Median
$416.87
Typical High
$1,318.26
Premera BCBS
Setting
Facility
Modifier
Global
Typical Low
$354.81
Median
$398.11
Typical High
$416.87
Premera BCBS
Setting
Professional
Modifier
Global
Typical Low
$323.59
Median
$398.11
Typical High
$416.87
Providence
Setting
Facility
Modifier
Global
Typical Low
$120.23
Median
$120.23
Typical High
$416.87
Providence
Setting
Professional
Modifier
Global
Typical Low
$60.26
Median
$269.15
Typical High
$389.05
United
Setting
Facility
Modifier
Global
Typical Low
$245.47
Median
$275.42
Typical High
$295.12
United
Setting
Professional
Modifier
Global
Typical Low
$194.98
Median
$199.53
Typical High
$891.25