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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 October 2026.

How much does Above Elbow Disarticulation, Ultra-Light Material cost?

$269

Typical negotiated rate. In Utah, October 2026.

Insurers have agreed to pay about $269 for this service. The price depends on where it is billed: about $269 from a physician practice, and about $269 from a hospital or other facility.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 7 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$269$186 to $309
FacilityA hospital or hospital-owned outpatient department$269$120 to $417

How much rates vary

Facilitymedian $269 · 10th to 90th $120 to $417Professionalmedian $269 · 10th to 90th $120 to $380
$100$200$500facility $269professional $269

Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$120.23
Median
$120.23
Typical High
$120.23
Aetna
Setting
Professional
Modifier
None
Typical Low
$120.23
Median
$120.23
Typical High
$131.83
Cigna
Setting
Facility
Modifier
None
Typical Low
$269.15
Median
$269.15
Typical High
$295.12
Cigna
Setting
Professional
Modifier
None
Typical Low
$194.98
Median
$194.98
Typical High
$269.15
Molina
Setting
Professional
Modifier
None
Typical Low
$190.55
Median
$309.03
Typical High
$389.05
Regence BlueShield
Setting
Facility
Modifier
None
Typical Low
$398.11
Median
$416.87
Typical High
$630.96
Regence BlueShield
Setting
Professional
Modifier
None
Typical Low
$302.00
Median
$302.00
Typical High
$302.00
Select Health
Setting
Facility
Modifier
None
Typical Low
$426.58
Median
$426.58
Typical High
$426.58
Select Health
Setting
Professional
Modifier
None
Typical Low
$213.80
Median
$416.87
Typical High
$426.58
U of Utah Health Plan
Setting
Professional
Modifier
None
Typical Low
$263.03
Median
$338.84
Typical High
$489.78
United
Setting
Professional
Modifier
None
Typical Low
$144.54
Median
$186.21
Typical High
$338.84

Where Utah sits

The same service costs 2.6 times more in Kansas than in Delaware. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Utah· 21st of 51

$269

KS $501DE $195

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.