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Minnesota rates for HCPCS L7403

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

Facilitymedian $525 · 10th–90th $380–$3,2360%20%10th90th$525Professionalmedian $447 · 10th–90th $219–$5130%20%40%10th90th$447$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
$371.54 / $371.54 / $371.54
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$190.55 / $263.03 / $371.54
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$436.52 / $446.68 / $575.44
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$354.81 / $446.68 / $446.68
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,023.29 / $1,659.59 / $3,981.07
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$512.86 / $588.84 / $660.69
Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,318.26 / $1,659.59 / $3,235.94
Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$512.86 / $512.86 / $707.95
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$190.55 / $446.68 / $2,089.30
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$131.83 / $199.53 / $489.78
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3.16 / $263.03 / $645.65
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $234.42 / $616.60