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Ohio rates for HCPCS L7401

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

Facilitymedian $447 · 10th–90th $245–$7410%20%40%10th90th$447Professionalmedian $214 · 10th–90th $178–$3630%20%10th90th$214$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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$204.17 / $204.17 / $346.74
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$173.78 / $204.17 / $338.84
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$426.58 / $446.68 / $912.01
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$208.93 / $257.04 / $549.54
Aultcare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$354.81 / $354.81 / $354.81
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$208.93 / $354.81 / $501.19
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $371.54 / $562.34
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$269.15 / $269.15 / $281.84
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$194.98 / $194.98 / $269.15
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$269.15 / $269.15 / $269.15
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$194.98 / $194.98 / $269.15
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$223.87 / $354.81 / $512.86
SummaCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$501.19 / $501.19 / $501.19
SummaCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$398.11 / $467.74 / $870.96
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$165.96 / $338.84 / $501.19
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $204.17 / $281.84