go back

Arizona 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
Professional
Modifier
Low / Median / High Price
$190.55 / $223.87 / $870.96
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$114.82 / $263.03 / $549.54
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$331.13 / $436.52 / $831.76
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$316.23 / $316.23 / $316.23
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$234.42 / $234.42 / $316.23
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$128.82 / $281.84 / $912.01
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$181.97 / $199.53 / $2,238.72
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$154.88 / $309.03 / $346.74
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$181.97 / $199.53 / $302.00