go back

Above Elbow Disarticulation, Ultra-Light Material

Ohio 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 $437 · 10th–90th $209$7080%20%40%10th90th$437Professionalmedian $224 · 10th–90th $195$4470%20%10th90th$224$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
Facility
Modifier
Global
Typical Low
$204.17
Median
$204.17
Typical High
$346.74
Aetna
Setting
Professional
Modifier
Global
Typical Low
$186.21
Median
$204.17
Typical High
$346.74
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$426.58
Median
$446.68
Typical High
$912.01
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$208.93
Median
$257.04
Typical High
$549.54
Aultcare
Setting
Professional
Modifier
Global
Typical Low
$363.08
Median
$363.08
Typical High
$363.08
CareSource
Setting
Facility
Modifier
Global
Typical Low
$208.93
Median
$354.81
Typical High
$501.19
CareSource
Setting
Professional
Modifier
Global
Typical Low
$269.15
Median
$371.54
Typical High
$562.34
Cigna
Setting
Facility
Modifier
Global
Typical Low
$269.15
Median
$269.15
Typical High
$295.12
Cigna
Setting
Professional
Modifier
Global
Typical Low
$194.98
Median
$194.98
Typical High
$295.12
Medical Mutual of Ohio
Setting
Facility
Modifier
Global
Typical Low
$269.15
Median
$269.15
Typical High
$281.84
Medical Mutual of Ohio
Setting
Professional
Modifier
Global
Typical Low
$194.98
Median
$194.98
Typical High
$208.93
Molina
Setting
Professional
Modifier
Global
Typical Low
$223.87
Median
$354.81
Typical High
$512.86
SummaCare
Setting
Professional
Modifier
Global
Typical Low
$426.58
Median
$467.74
Typical High
$870.96
United
Setting
Facility
Modifier
Global
Typical Low
$245.47
Median
$338.84
Typical High
$426.58
United
Setting
Professional
Modifier
Global
Typical Low
$138.04
Median
$208.93
Typical High
$295.12