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Above Elbow Disarticulation, Ultra-Light Material

Texas 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 $339 · 10th–90th $182$8320%10%20%10th90th$339Professionalmedian $200 · 10th–90th $178$3630%20%10th90th$200$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
$181.97
Median
$194.98
Typical High
$338.84
Aetna
Setting
Professional
Modifier
Global
Typical Low
$177.83
Median
$204.17
Typical High
$363.08
BCBS
Setting
Professional
Modifier
Global
Typical Low
$199.53
Median
$199.53
Typical High
$199.53
Christus
Setting
Facility
Modifier
Global
Typical Low
$79.43
Median
$426.58
Typical High
$426.58
Cigna
Setting
Facility
Modifier
Global
Typical Low
$269.15
Median
$269.15
Typical High
$269.15
Cigna
Setting
Professional
Modifier
Global
Typical Low
$194.98
Median
$194.98
Typical High
$269.15
Lucent Health
Setting
Facility
Modifier
Global
Typical Low
$1,949.84
Median
$1,949.84
Typical High
$1,949.84
Lucent Health
Setting
Professional
Modifier
Global
Typical Low
$2,137.96
Median
$3,019.95
Typical High
$3,019.95
Moda Health
Setting
Facility
Modifier
Global
Typical Low
$181.97
Median
$363.08
Typical High
$549.54
Moda Health
Setting
Professional
Modifier
Global
Typical Low
$257.04
Median
$389.05
Typical High
$426.58
Molina
Setting
Professional
Modifier
Global
Typical Low
$316.23
Median
$316.23
Typical High
$316.23
Providence
Setting
Facility
Modifier
Global
Typical Low
$181.97
Median
$338.84
Typical High
$549.54
Providence
Setting
Professional
Modifier
Global
Typical Low
$194.98
Median
$194.98
Typical High
$269.15
United
Setting
Facility
Modifier
Global
Typical Low
$208.93
Median
$338.84
Typical High
$426.58
United
Setting
Professional
Modifier
Global
Typical Low
$154.88
Median
$229.09
Typical High
$281.84
Wellpoint
Setting
Professional
Modifier
Global
Typical Low
$223.87
Median
$426.58
Typical High
$575.44