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Connecticut rates for HCPCS L7402

Addition To Upper Extremity Prosthesis Shoulder Disarticulation/Interscapular Thoracic Ultralight Material (Titanium Carbon Fiber Or Equal)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$212.20 / $212.20 / $212.20
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$190.00 / $196.88 / $212.63
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$338.37 / $436.60 / $499.51
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$243.00 / $243.00 / $255.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$318.35 / $318.35 / $318.35
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$232.40 / $232.40 / $318.35
ConnectiCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$283.79 / $283.79 / $283.79
ConnectiCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$283.79 / $283.79 / $401.67
Health New England
Facility/Professional
Professional
Modifier
Low / Median / High Price
$332.42 / $332.42 / $332.42
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$166.23 / $217.82 / $307.20