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Wyoming rates for HCPCS L7402

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$226.11 / $226.11 / $395.97
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$441.61 / $441.61 / $441.61
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$441.61 / $441.61 / $441.61
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$318.35 / $318.35 / $489.67
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$232.40 / $232.40 / $318.35
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$180.18 / $199.36 / $447.32