go back

Kentucky 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
$213.80 / $213.80 / $223.87
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$190.55 / $218.78 / $371.54
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$416.87 / $457.09 / $478.63
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$208.93 / $239.88 / $245.47
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$338.84 / $602.56 / $794.33
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$446.68 / $562.34 / $724.44
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$316.23 / $707.95 / $707.95
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$234.42 / $457.09 / $2,137.96
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$263.03 / $263.03 / $316.23
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$147.91 / $223.87 / $309.03