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Washington 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 $282–$1,0470%20%10th90th$447Professionalmedian $316 · 10th–90th $195–$6460%20%10th90th$316$1.0$5.0$20.0$100.0$500.0$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
$281.84 / $281.84 / $676.08
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$190.55 / $239.88 / $389.05
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$380.19 / $426.58 / $426.58
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$380.19 / $380.19 / $489.78
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$316.23 / $316.23 / $316.23
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$234.42 / $234.42 / $316.23
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$251.19 / $588.84 / $1,230.27
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$251.19 / $524.81 / $933.25
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $331.13 / $371.54
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$426.58 / $426.58 / $446.68
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$380.19 / $645.65 / $870.96
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$363.08 / $363.08 / $426.58
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$426.58 / $426.58 / $426.58
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$380.19 / $380.19 / $489.78
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$263.03 / $645.65 / $645.65
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $269.15 / $380.19
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$245.47 / $309.03 / $660.69