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Pennsylvania rates for HCPCS L7402

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

Facilitymedian $550 · 10th–90th $195$7590%20%10th90th$550Professionalmedian $224 · 10th–90th $191$3980%20%40%10th90th$224$0.5$5.0$50.0$500.0$5.0K$50.0K

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
Facility
Modifier
Typical Low / Median / Typical High
$194.98 / $758.58 / $758.58
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$190.55 / $218.78 / $371.54
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,011.87 / $8,511.38 / $77,624.71
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$436.52 / $436.52 / $436.52
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$316.23 / $316.23 / $446.68
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$234.42 / $234.42 / $316.23
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$407.38 / $588.84 / $851.14
Geisinger
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$446.68 / $446.68 / $446.68
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $309.03 / $446.68
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$194.98 / $194.98 / $194.98
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$190.55 / $218.78 / $371.54
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.60 / $616.60 / $851.14
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$309.03 / $309.03 / $416.87
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$309.03 / $416.87 / $467.74
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$181.97 / $549.54 / $630.96
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $239.88 / $446.68