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Above Elbow Disarticulation, Ultra-Light Material

Utah 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 $245 · 10th–90th $120$4170%20%40%10th90th$245Professionalmedian $245 · 10th–90th $120$1,7380%10%10th90th$245$50.0$100.0$200.0$500.0$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
$120.23
Median
$120.23
Typical High
$120.23
Aetna
Setting
Professional
Modifier
Global
Typical Low
$120.23
Median
$181.97
Typical High
$1,737.80
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
Molina
Setting
Professional
Modifier
Global
Typical Low
$60.26
Median
$309.03
Typical High
$389.05
Regence BlueShield
Setting
Facility
Modifier
Global
Typical Low
$398.11
Median
$416.87
Typical High
$416.87
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$234.42
Median
$302.00
Typical High
$457.09
Select Health
Setting
Facility
Modifier
Global
Typical Low
$426.58
Median
$426.58
Typical High
$426.58
Select Health
Setting
Professional
Modifier
Global
Typical Low
$213.80
Median
$416.87
Typical High
$426.58
U of Utah Health Plan
Setting
Professional
Modifier
Global
Typical Low
$302.00
Median
$426.58
Typical High
$489.78
United
Setting
Facility
Modifier
Global
Typical Low
$154.88
Median
$245.47
Typical High
$295.12
United
Setting
Professional
Modifier
Global
Typical Low
$144.54
Median
$186.21
Typical High
$281.84