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South Dakota rates for HCPCS L7401

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

Facilitymedian $347 · 10th–90th $309–$6920%20%40%10th90th$347Professionalmedian $347 · 10th–90th $182–$5620%20%10th90th$347$200.0$500.0$1.0K$2.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$302.00 / $346.74 / $346.74
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$181.97 / $338.84 / $407.38
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$269.15 / $269.15 / $467.74
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$478.63 / $478.63 / $602.56
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$331.13 / $426.58 / $1,122.02
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$165.96 / $281.84 / $2,089.30
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$380.19 / $457.09 / $457.09
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$467.74 / $467.74 / $467.74
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$380.19 / $380.19 / $758.58
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$346.74 / $416.87 / $549.54
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$144.54 / $281.84 / $489.78
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$407.38 / $407.38 / $407.38