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Oklahoma 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
$192.94 / $192.94 / $192.94
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$192.94 / $220.51 / $222.58
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 / $318.35
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$128.69 / $270.08 / $2,083.02
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$132.90 / $263.43 / $455.21
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$149.56 / $214.34 / $300.30