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North Carolina rates for HCPCS L7403

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

Facilitymedian $331 · 10th–90th $195–$8130%20%10th90th$331Professionalmedian $295 · 10th–90th $191–$3390%20%40%10th90th$295$0.5$5.0$50.0$500.0$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
$331.13 / $331.13 / $331.13
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$190.55 / $275.42 / $331.13
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$338.84 / $338.84 / $380.19
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 / $208.93 / $309.03
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$208.93 / $223.87 / $295.12
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$186.21 / $371.54 / $660.69
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$165.96 / $295.12 / $363.08
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$173.78 / $223.87 / $316.23
Wellcare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,089.30 / $2,089.30 / $2,089.30
Wellcare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,290.87 / $2,290.87 / $3,235.94