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Illinois rates for HCPCS L7403

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

Facilitymedian $501 · 10th–90th $219$2,2910%20%10th90th$501Professionalmedian $251 · 10th–90th $195$4570%20%10th90th$251$0.5$2.0$10.0$50.0$200.0$1.0K$5.0K

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
Setting
Facility
Modifier
Global
Typical Low
$218.78
Median
$218.78
Typical High
$457.09
Aetna
Setting
Professional
Modifier
Global
Typical Low
$190.55
Median
$229.09
Typical High
$436.52
BCBS
Setting
Facility
Modifier
Global
Typical Low
$537.03
Median
$870.96
Typical High
$3,090.30
BCBS
Setting
Professional
Modifier
Global
Typical Low
$338.84
Median
$338.84
Typical High
$338.84
Cigna
Setting
Facility
Modifier
Global
Typical Low
$288.40
Median
$288.40
Typical High
$501.19
Cigna
Setting
Professional
Modifier
Global
Typical Low
$208.93
Median
$208.93
Typical High
$512.86
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$380.19
Median
$549.54
Typical High
$660.69
Hally Health
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$575.44
Median
$575.44
Typical High
$575.44
Molina
Setting
Professional
Modifier
Global
Typical Low
$269.15
Median
$269.15
Typical High
$389.05
United
Setting
Facility
Modifier
Global
Typical Low
$263.03
Median
$363.08
Typical High
$645.65
United
Setting
Professional
Modifier
Global
Typical Low
$173.78
Median
$223.87
Typical High
$371.54