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Michigan rates for HCPCS L7403

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

Facilitymedian $537 · 10th–90th $251–$1,7780%20%10th90th$537Professionalmedian $245 · 10th–90th $195–$4470%20%10th90th$245$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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$251.19 / $251.19 / $251.19
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $229.09 / $331.13
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$588.84 / $1,348.96 / $2,570.40
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$446.68 / $446.68 / $467.74
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$288.40 / $288.40 / $288.40
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 / $288.40 / $489.78
Health Alliance Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$251.19 / $851.14 / $954.99
Health Alliance Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$229.09 / $354.81 / $549.54
Priority Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$288.40 / $288.40 / $288.40
Priority Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$208.93 / $309.03 / $446.68
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$263.03 / $363.08 / $537.03
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$165.96 / $213.80 / $302.00