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Minnesota 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
$374.68 / $374.68 / $374.68
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$206.48 / $351.89 / $374.68
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$383.19 / $447.32 / $622.88
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$357.86 / $424.95 / $447.32
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$318.35 / $1,380.09 / $3,833.08
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$518.63 / $549.74 / $658.65
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$819.34 / $1,324.13 / $3,018.18
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$518.63 / $518.63 / $533.60
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$132.56 / $447.32 / $2,083.02
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$132.90 / $222.95 / $449.19
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$156.09 / $240.94 / $785.72