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Georgia 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
$186.21 / $535.71 / $1,024.48
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$186.21 / $235.15 / $297.94
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$447.00 / $625.79 / $1,640.49
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$253.76 / $371.68 / $713.63
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$368.82 / $379.95 / $826.95
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$379.95 / $379.95 / $379.95
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 / $530.47
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$339.72 / $447.00 / $991.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$178.90 / $223.01 / $444.59