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Utah rates for HCPCS L7401

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

Facilitymedian $269 · 10th–90th $120–$4170%20%40%10th90th$269Professionalmedian $302 · 10th–90th $120–$1,7380%10%10th90th$302$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$120.23 / $120.23 / $120.23
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $223.87 / $1,737.80
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$269.15 / $269.15 / $269.15
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$194.98 / $194.98 / $269.15
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $309.03 / $389.05
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$398.11 / $416.87 / $416.87
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$288.40 / $302.00 / $457.09
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$407.38 / $416.87 / $426.58
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$302.00 / $426.58 / $489.78
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$154.88 / $245.47 / $275.42
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$144.54 / $186.21 / $309.03