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Massachusetts rates for HCPCS L7403

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

Facilitymedian $234 · 10th–90th $191$2,0890%20%40%10th90th$234Professionalmedian $295 · 10th–90th $191$4270%20%10th90th$295$0.5$5.0$50.0$500.0$5.0K$50.0K

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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$190.55 / $190.55 / $190.55
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $218.78 / $389.05
AllWays Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$407.38 / $426.58 / $2,089.30
AllWays Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$199.53 / $338.84 / $489.78
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$288.40 / $288.40 / $288.40
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$208.93 / $208.93 / $309.03
Fallon Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$60.26 / $3,630.78 / $9,772.37
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$380.19 / $380.19 / $575.44
Health New England
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$331.13 / $331.13 / $331.13
Mass General Brigham
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$407.38 / $426.58 / $2,089.30
Mass General Brigham
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$199.53 / $338.84 / $489.78
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$125.89 / $295.12 / $537.03
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$194.98 / $302.00 / $380.19