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Arizona rates for HCPCS L7403

Addition to upper extremity prosthesis, below elbow/wrist disarticulation, acrylic material

Facilitymedian $355 · 10th–90th $129–$8510%10%10th90th$355Professionalmedian $229 · 10th–90th $186–$3980%20%10th90th$229$0.5$2.0$10.0$50.0$200.0$1.0K

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
Professional
Modifier
Typical Low / Median / Typical High
$190.55 / $229.09 / $389.05
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$338.84 / $338.84 / $338.84
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$114.82 / $467.74 / $891.25
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$331.13 / $436.52 / $831.76
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$288.40 / $288.40 / $288.40
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$208.93 / $208.93 / $288.40
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$128.82 / $288.40 / $912.01
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$177.83 / $199.53 / $2,238.72
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$263.03 / $354.81 / $354.81
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $199.53 / $295.12