go back

Iowa rates for HCPCS L7401

Addition To Upper Extremity Prosthesis Above Elbow Disarticulation Ultralight Material (Titanium Carbon Fiber Or Equal)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$304.68 / $346.90 / $346.90
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$173.49 / $222.24 / $350.09
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$267.94 / $267.94 / $453.39
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$267.94 / $480.00 / $600.00
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$393.46 / $437.20 / $535.72
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$262.85 / $535.82 / $1,928.91
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$197.04 / $257.87 / $563.14
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$452.06 / $453.39 / $562.12
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$371.33 / $529.62 / $866.41
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$197.04 / $208.35 / $538.41
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$403.93 / $403.93 / $403.93
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$319.10 / $403.93 / $403.93