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Pennsylvania rates for HCPCS L7401

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

Facilitymedian $501 · 10th–90th $182–$6920%20%10th90th$501Professionalmedian $204 · 10th–90th $178–$3630%20%10th90th$204$0.5$5.0$50.0$500.0$5.0K$50.0K

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
$181.97 / $691.83 / $691.83
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$173.78 / $204.17 / $346.74
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,011.87 / $8,511.38 / $77,624.71
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$407.38 / $407.38 / $407.38
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$269.15 / $269.15 / $416.87
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$194.98 / $194.98 / $269.15
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$380.19 / $537.03 / $776.25
Geisinger
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$416.87 / $416.87 / $416.87
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$245.47 / $288.40 / $416.87
Highmark BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$302.00 / $302.00 / $302.00
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$181.97 / $181.97 / $181.97
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$177.83 / $204.17 / $346.74
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.60 / $575.44 / $794.33
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$288.40 / $288.40 / $389.05
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$288.40 / $309.03 / $398.11
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$165.96 / $501.19 / $575.44
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$169.82 / $223.87 / $416.87