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Minnesota 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
$346.90 / $346.90 / $346.90
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$191.22 / $325.85 / $346.90
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$354.79 / $414.17 / $576.71
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$331.34 / $393.46 / $414.17
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$267.94 / $1,277.67 / $3,548.62
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$480.00 / $508.80 / $609.60
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$758.54 / $1,225.85 / $2,794.19
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$480.00 / $480.00 / $494.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$122.75 / $414.17 / $1,928.91
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$123.07 / $206.45 / $415.90
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$123.07 / $206.14 / $398.06