go back

Colorado rates for HCPCS L7403

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$224.72 / $224.72 / $224.72
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$140.58 / $224.72 / $336.56
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$449.44 / $504.99 / $916.86
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$267.12 / $267.12 / $288.49
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
Denver HMP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$127.91 / $224.72 / $597.23
Denver HMP
Facility/Professional
Professional
Modifier
Low / Median / High Price
$127.91 / $127.91 / $127.91
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$328.09 / $561.79 / $898.88
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$183.19 / $198.13 / $305.32