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Arizona rates for HCPCS L7403

Addition To Upper Extremity Prosthesis Below Elbow/Wrist Disarticulation Acrylic Material

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$195.26 / $199.97 / $332.70
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$113.91 / $411.51 / $743.99
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$284.77 / $379.71 / $517.36
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$286.80 / $286.80 / $286.80
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$209.36 / $209.36 / $515.25
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$127.91 / $238.53 / $2,070.19
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$179.08 / $198.13 / $305.32
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$183.19 / $198.13 / $298.45