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Below Elbow or Wrist Disarticulation, Acrylic Material

Michigan rates for HCPCS L7403

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

Rates data updated October 2026.

How much does Below Elbow or Wrist Disarticulation, Acrylic Material cost?

$339

Typical negotiated rate. In Michigan, October 2026.

Insurers have agreed to pay about $339 for this service. The price depends on where it is billed: about $324 from a physician practice, and about $794 from a hospital or other facility.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 7 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$324$251 to $447
FacilityA hospital or hospital-owned outpatient department$794$288 to $1,380

How much rates vary

Facilitymedian $794 · 10th to 90th $288 to $1,950Professionalmedian $324 · 10th to 90th $214 to $457
$200$500$1K$2Kfacility $794professional $324

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$251.19
Median
$251.19
Typical High
$446.68
Aetna
Setting
Professional
Modifier
None
Typical Low
$251.19
Median
$251.19
Typical High
$446.68
BCBS Michigan
Setting
Facility
Modifier
None
Typical Low
$537.03
Median
$1,318.26
Typical High
$2,511.89
BCBS Michigan
Setting
Professional
Modifier
None
Typical Low
$426.58
Median
$446.68
Typical High
$446.68
CareSource
Setting
Facility
Modifier
None
Typical Low
$288.40
Median
$288.40
Typical High
$288.40
Cigna
Setting
Facility
Modifier
None
Typical Low
$288.40
Median
$288.40
Typical High
$288.40
Cigna
Setting
Professional
Modifier
None
Typical Low
$208.93
Median
$288.40
Typical High
$489.78
Health Alliance Plan
Setting
Facility
Modifier
None
Typical Low
$251.19
Median
$870.96
Typical High
$954.99
Health Alliance Plan
Setting
Professional
Modifier
None
Typical Low
$251.19
Median
$354.81
Typical High
$457.09
Priority Health
Setting
Facility
Modifier
None
Typical Low
$288.40
Median
$288.40
Typical High
$288.40
Priority Health
Setting
Professional
Modifier
None
Typical Low
$208.93
Median
$288.40
Typical High
$446.68
United
Setting
Facility
Modifier
None
Typical Low
$457.09
Median
$537.03
Typical High
$645.65
United
Setting
Professional
Modifier
None
Typical Low
$165.96
Median
$213.80
Typical High
$302.00
1 more rate with less common billing modifiers

A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.

Insurance Carrier
BCBS Michigan
Setting
Professional
Modifier
RR · Rental
Typical Low
$446.68
Median
$446.68
Typical High
$446.68

Where Michigan sits

The same service costs 2.4 times more in Kansas than in Delaware. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Michigan· 17th of 51

$339

KS $501DE $209

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.