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Above Elbow Disarticulation, Ultra-Light Material

Montana 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 $407 · 10th–90th $269$5130%20%40%10th90th$407Professionalmedian $339 · 10th–90th $120$7940%10%20%10th90th$339$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
$120.23
Median
$338.84
Typical High
$1,737.80
Cigna
Setting
Facility
Modifier
Global
Typical Low
$269.15
Median
$436.52
Typical High
$436.52
Cigna
Setting
Professional
Modifier
Global
Typical Low
$194.98
Median
$436.52
Typical High
$436.52
MountainHealth Co-op
Setting
Facility
Modifier
Global
Typical Low
$323.59
Median
$407.38
Typical High
$794.33
MountainHealth Co-op
Setting
Professional
Modifier
Global
Typical Low
$323.59
Median
$407.38
Typical High
$794.33
Providence
Setting
Facility
Modifier
Global
Typical Low
$194.98
Median
$389.05
Typical High
$588.84
Providence
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$331.13
Typical High
$436.52
United
Setting
Facility
Modifier
Global
Typical Low
$245.47
Median
$275.42
Typical High
$295.12
United
Setting
Professional
Modifier
Global
Typical Low
$165.96
Median
$186.21
Typical High
$281.84