go back

Virginia rates for HCPCS L7401

Addition To Upper Extremity Prosthesis Above Elbow Disarticulation Ultralight Material (Titanium Carbon Fiber Or Equal)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$213.22 / $213.22 / $215.49
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$196.90 / $213.22 / $222.24
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$404.30 / $404.30 / $429.37
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$248.87 / $248.87 / $311.11
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$245.95 / $245.95 / $276.37
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$267.94 / $267.94 / $267.94
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$195.60 / $195.60 / $267.94
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$283.01 / $363.87 / $485.16
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$119.17 / $248.64 / $451.72
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$304.74 / $531.04 / $673.42
Sentara
Facility/Professional
Facility
Modifier
Low / Median / High Price
$221.49 / $310.80 / $516.49
Sentara
Facility/Professional
Professional
Modifier
Low / Median / High Price
$221.49 / $310.80 / $516.49
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$184.60 / $201.70 / $289.35