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New Mexico rates for HCPCS L7403

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

Facilitymedian $302 · 10th–90th $129–$4570%10%20%10th90th$302Professionalmedian $240 · 10th–90th $195–$3890%20%10th90th$240$100.0$200.0$500.0$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
$245.47 / $245.47 / $245.47
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$194.98 / $239.88 / $389.05
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $354.81 / $426.58
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 / $549.54
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$354.81 / $446.68 / $676.08
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$128.82 / $316.23 / $457.09
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$208.93 / $208.93 / $457.09
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$263.03 / $302.00 / $537.03
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$177.83 / $199.53 / $295.12