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Missouri rates for HCPCS L7403

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

Facilitymedian $363 · 10th–90th $219–$9120%20%10th90th$363Professionalmedian $245 · 10th–90th $191–$4170%20%10th90th$245$0.5$2.0$10.0$50.0$200.0$1.0K

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
$204.17 / $295.12 / $295.12
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $229.09 / $416.87
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$446.68 / $446.68 / $1,584.89
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$234.42 / $269.15 / $416.87
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 / $302.00
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$208.93 / $208.93 / $288.40
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$223.87 / $354.81 / $1,000.00
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $223.87 / $2,238.72
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$263.03 / $363.08 / $363.08
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$165.96 / $218.78 / $323.59