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Maine rates for HCPCS L7403

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

Facilitymedian $513 · 10th–90th $288–$5890%20%40%10th90th$513Professionalmedian $257 · 10th–90th $191–$4470%10%20%10th90th$257$200.0$500.0$1.0K$2.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$190.55 / $234.42 / $660.69
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$426.58 / $512.86 / $588.84
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $269.15 / $446.68
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 / $288.40
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$380.19 / $380.19 / $457.09
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$190.55 / $251.19 / $295.12
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$125.89 / $263.03 / $263.03
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$169.82 / $371.54 / $380.19