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Washington rates for HCPCS L7401

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

Facilitymedian $417 · 10th–90th $263–$9770%20%10th90th$417Professionalmedian $288 · 10th–90th $182–$6030%20%10th90th$288$1.0$5.0$20.0$100.0$500.0$2.0K

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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$263.03 / $263.03 / $616.60
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$177.83 / $223.87 / $363.08
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$346.74 / $398.11 / $398.11
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$346.74 / $346.74 / $457.09
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
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$234.42 / $549.54 / $1,148.15
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$234.42 / $478.63 / $851.14
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $309.03 / $338.84
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$398.11 / $407.38 / $407.38
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$354.81 / $588.84 / $812.83
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$338.84 / $338.84 / $398.11
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$398.11 / $398.11 / $398.11
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$346.74 / $346.74 / $457.09
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$245.47 / $602.56 / $602.56
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$173.78 / $245.47 / $354.81
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$251.19 / $288.40 / $616.60