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Above Elbow Disarticulation, Ultra-Light Material

Idaho 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 $389 · 10th–90th $257$5130%20%10th90th$389Professionalmedian $302 · 10th–90th $186$4570%10%20%10th90th$302$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
Setting
Professional
Modifier
Global
Typical Low
$208.93
Median
$263.03
Typical High
$338.84
BCBS
Setting
Facility
Modifier
Global
Typical Low
$323.59
Median
$389.05
Typical High
$660.69
BCBS
Setting
Professional
Modifier
Global
Typical Low
$426.58
Median
$457.09
Typical High
$457.09
Cigna
Setting
Facility
Modifier
Global
Typical Low
$251.19
Median
$269.15
Typical High
$281.84
Cigna
Setting
Professional
Modifier
Global
Typical Low
$194.98
Median
$194.98
Typical High
$269.15
Moda Health
Setting
Facility
Modifier
Global
Typical Low
$120.23
Median
$371.54
Typical High
$436.52
Moda Health
Setting
Professional
Modifier
Global
Typical Low
$338.84
Median
$389.05
Typical High
$416.87
Molina
Setting
Professional
Modifier
Global
Typical Low
$30.20
Median
$30.20
Typical High
$346.74
Regence BlueShield
Setting
Facility
Modifier
Global
Typical Low
$389.05
Median
$398.11
Typical High
$398.11
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$288.40
Median
$288.40
Typical High
$457.09
Select Health
Setting
Facility
Modifier
Global
Typical Low
$416.87
Median
$416.87
Typical High
$616.60
Select Health
Setting
Professional
Modifier
Global
Typical Low
$269.15
Median
$389.05
Typical High
$446.68
United
Setting
Facility
Modifier
Global
Typical Low
$0.28
Median
$275.42
Typical High
$295.12
United
Setting
Professional
Modifier
Global
Typical Low
$169.82
Median
$186.21
Typical High
$281.84