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Below Elbow or Wrist Disarticulation, Acrylic Material

Montana 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?

$457

Typical negotiated rate. In Montana, October 2026.

Insurers have agreed to pay about $457 for this service. The price depends on where it is billed: about $437 from a physician practice, and about $501 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 6 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$437$234 to $468
FacilityA hospital or hospital-owned outpatient department$501$457 to $26,303

How much rates vary

Facilitymedian $501 · 10th to 90th $347 to $26,915Professionalmedian $437 · 10th to 90th $79 to $501
$100$500$2K$10Kfacility $501professional $437

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
Professional
Modifier
None
Typical Low
$128.82
Median
$363.08
Typical High
$389.05
BCBS Montana
Setting
Professional
Modifier
None
Typical Low
$436.52
Median
$436.52
Typical High
$436.52
Cigna
Setting
Facility
Modifier
None
Typical Low
$416.87
Median
$467.74
Typical High
$467.74
Cigna
Setting
Professional
Modifier
None
Typical Low
$380.19
Median
$467.74
Typical High
$467.74
MountainHealth Co-op
Setting
Facility
Modifier
None
Typical Low
$346.74
Median
$575.44
Typical High
$26,915.35
MountainHealth Co-op
Setting
Professional
Modifier
None
Typical Low
$457.09
Median
$501.19
Typical High
$28,183.83
Providence
Setting
Facility
Modifier
None
Typical Low
$288.40
Median
$467.74
Typical High
$467.74
Providence
Setting
Professional
Modifier
None
Typical Low
$79.43
Median
$354.81
Typical High
$467.74
United
Setting
Professional
Modifier
None
Typical Low
$190.55
Median
$199.53
Typical High
$331.13

Where Montana 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.

Montana· 2nd of 51

$457

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.