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South Carolina rates for HCPCS L7402

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

Facilitymedian $302 · 10th–90th $200–$5750%10%20%10th90th$302Professionalmedian $224 · 10th–90th $191–$3630%10%20%10th90th$224$50.0$100.0$200.0$500.0$1.0K$2.0K

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
$199.53 / $199.53 / $199.53
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$190.55 / $223.87 / $331.13
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$457.09 / $478.63 / $575.44
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$316.23 / $316.23 / $354.81
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$234.42 / $234.42 / $512.86
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$223.87 / $223.87 / $223.87
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$199.53 / $331.13 / $707.95
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$128.82 / $128.82 / $128.82
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $302.00
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$263.03 / $302.00 / $549.54
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$165.96 / $223.87 / $302.00