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Montana rates for HCPCS L7402

Addition to upper extremity prosthesis, shoulder disarticulation/interscapular thoracic, ultra-light material (titanium, carbon fiber or equal)

Facilitymedian $447 · 10th–90th $309–$5500%20%40%10th90th$447Professionalmedian $282 · 10th–90th $141–$5500%10%10th90th$282$100.0$200.0$500.0$1.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$141.25 / $263.03 / $398.11
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$316.23 / $478.63 / $478.63
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$316.23 / $478.63 / $478.63
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$346.74 / $446.68 / $870.96
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$346.74 / $446.68 / $870.96
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$213.80 / $416.87 / $645.65
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $354.81 / $478.63
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$263.03 / $302.00 / $316.23
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$181.97 / $199.53 / $309.03