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Below Elbow or Wrist Disarticulation, Acrylic Material

New Hampshire 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?

$269

Typical negotiated rate. In New Hampshire, October 2026.

Insurers have agreed to pay about $269 for this service. The price depends on where it is billed: about $269 from a physician practice, and about $447 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$269$219 to $275
FacilityA hospital or hospital-owned outpatient department$447$407 to $479

How much rates vary

Facilitymedian $447 · 10th to 90th $288 to $537Professionalmedian $269 · 10th to 90th $209 to $380
$200$500facility $447professional $269

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

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
None
Typical Low
$190.55
Median
$245.47
Typical High
$245.47
Anthem BCBS
Setting
Facility
Modifier
None
Typical Low
$407.38
Median
$467.74
Typical High
$549.54
Anthem BCBS
Setting
Professional
Modifier
None
Typical Low
$269.15
Median
$269.15
Typical High
$275.42
Anthem BCBS
Setting
Professional
Modifier
RR · Rental
Typical Low
$26.92
Median
$26.92
Typical High
$26.92
Anthem BCBS
Setting
Professional
Modifier
UE · Used equipment
Typical Low
$199.53
Median
$199.53
Typical High
$199.53
Cigna
Setting
Facility
Modifier
None
Typical Low
$288.40
Median
$288.40
Typical High
$316.23
Cigna
Setting
Professional
Modifier
None
Typical Low
$208.93
Median
$208.93
Typical High
$288.40
Harvard Pilgrim
Setting
Professional
Modifier
None
Typical Low
$199.53
Median
$380.19
Typical High
$616.60
United
Setting
Professional
Modifier
None
Typical Low
$144.54
Median
$218.78
Typical High
$354.81
Well Sense
Setting
Facility
Modifier
None
Typical Low
$436.52
Median
$436.52
Typical High
$436.52

Where New Hampshire 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.

New Hampshire· 34th of 51

$269

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.