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Washington, DC 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
$231.27 / $231.27 / $231.27
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$231.27 / $231.27 / $231.27
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$263.98 / $263.98 / $263.98
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$209.36 / $209.36 / $209.36
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$282.04 / $282.04 / $861.32
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$144.31 / $216.47 / $369.98