go back

Kansas 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
$371.54 / $371.54 / $371.54
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$190.55 / $234.42 / $371.54
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$660.69 / $691.83 / $741.31
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$588.84 / $588.84 / $588.84
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 / $512.86
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$128.82 / $309.03 / $1,000.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.83 / $223.87 / $2,238.72
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$263.03 / $354.81 / $354.81
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$147.91 / $223.87 / $309.03