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Above Elbow Disarticulation, Ultra-Light Material

Indiana rates for HCPCS L7401

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

Rates data updated October 2026.

How much does Above Elbow Disarticulation, Ultra-Light Material cost?

$251

Typical negotiated rate. In Indiana, October 2026.

Insurers have agreed to pay about $251 for this service. The price depends on where it is billed: about $251 from a physician practice, and about $427 from a hospital or other facility.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 6 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$251$224 to $295
FacilityA hospital or hospital-owned outpatient department$427$331 to $427

How much rates vary

Facilitymedian $427 · 10th to 90th $269 to $955Professionalmedian $251 · 10th to 90th $195 to $427
$200$500$1K$2Kfacility $427professional $251

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$194.98
Median
$194.98
Typical High
$194.98
Aetna
Setting
Professional
Modifier
None
Typical Low
$194.98
Median
$194.98
Typical High
$416.87
Anthem BCBS
Setting
Facility
Modifier
None
Typical Low
$331.13
Median
$426.58
Typical High
$446.68
Anthem BCBS
Setting
Professional
Modifier
None
Typical Low
$251.19
Median
$251.19
Typical High
$426.58
Anthem BCBS
Setting
Professional
Modifier
RR · Rental
Typical Low
$25.12
Median
$25.12
Typical High
$35.48
Anthem BCBS
Setting
Professional
Modifier
UE · Used equipment
Typical Low
$186.21
Median
$186.21
Typical High
$263.03
CareSource
Setting
Facility
Modifier
None
Typical Low
$602.56
Median
$602.56
Typical High
$630.96
Cigna
Setting
Facility
Modifier
None
Typical Low
$257.04
Median
$269.15
Typical High
$426.58
Cigna
Setting
Professional
Modifier
None
Typical Low
$194.98
Median
$269.15
Typical High
$2,041.74
Physicians Health Plan of Northern Indiana
Setting
Facility
Modifier
None
Typical Low
$912.01
Median
$954.99
Typical High
$2,137.96
Physicians Health Plan of Northern Indiana
Setting
Professional
Modifier
None
Typical Low
$263.03
Median
$346.74
Typical High
$512.86
United
Setting
Professional
Modifier
None
Typical Low
$123.03
Median
$208.93
Typical High
$346.74

Where Indiana sits

The same service costs 2.6 times more in Kansas than in Delaware. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Indiana· 34th of 51

$251

KS $501DE $195

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.