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Connecticut 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
$210.89 / $210.89 / $210.89
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$188.83 / $195.68 / $211.33
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$336.27 / $433.90 / $496.42
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$253.44 / $267.12 / $267.12
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 / $209.36
ConnectiCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$282.04 / $282.04 / $282.04
ConnectiCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$282.04 / $282.04 / $399.19
Health New England
Facility/Professional
Professional
Modifier
Low / Median / High Price
$330.40 / $330.40 / $330.40
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$165.20 / $216.47 / $305.32