go back

Massachusetts 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
$190.76 / $190.76 / $190.76
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$190.76 / $201.18 / $347.43
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$390.64 / $1,232.08 / $2,083.02
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$199.36 / $324.32 / $426.37
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$285.89 / $387.39 / $387.39
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 / $318.35 / $518.63
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$83.43 / $4,618.00 / $9,239.00
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$353.50 / $353.50 / $371.18
Health New England
Facility/Professional
Professional
Modifier
Low / Median / High Price
$332.42 / $332.42 / $332.42
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$908.06 / $2,083.02 / $2,083.02
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$170.55 / $233.38 / $426.37
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$196.66 / $258.62 / $426.37