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North Carolina 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
$309.98 / $309.98 / $629.07
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$186.31 / $309.98 / $309.98
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$333.90 / $400.68 / $760.81
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$289.95 / $312.36 / $312.36
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$267.94 / $267.94 / $267.94
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$195.60 / $267.94 / $480.00
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$119.17 / $309.98 / $500.26
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$304.74 / $304.74 / $304.74
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$485.20 / $485.20 / $745.90
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$159.63 / $207.77 / $312.66
Wellcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$695.81 / $1,928.91 / $1,928.91
Wellcare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,085.52 / $3,032.25 / $3,032.25