go back

Arkansas rates for HCPCS L7402

Addition to upper extremity prosthesis, shoulder disarticulation/interscapular thoracic, ultra-light material (titanium, carbon fiber or equal)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$249.94 / $249.94 / $249.94
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$190.00 / $249.94 / $249.94
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$219,999.78 / $539,999.46 / $949,999.05
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$388.21 / $513.80 / $570.90
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$436.60 / $436.60 / $449.71
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$436.60 / $436.60 / $436.60
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$318.35 / $318.35 / $359.75
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$232.40 / $318.35 / $351.32
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$149.56 / $224.34 / $307.20