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Below Elbow or Wrist Disarticulation, Acrylic Material

Ohio rates for HCPCS L7403

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

Rates data updated July 2026.

How much does Below Elbow or Wrist Disarticulation, Acrylic Material cost?

$257

Typical negotiated rate. In Ohio, July 2026.

Insurers have agreed to pay about $257 for this service. The price depends on where it is billed: about $240 from a physician practice, and about $468 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

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 9 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$240$219 to $324
FacilityA hospital or hospital-owned outpatient department$468$372 to $525

How much rates vary

Facilitymedian $468 · 10th to 90th $224 to $776Professionalmedian $240 · 10th to 90th $209 to $479
$1.0$10.0$100.0$1.0Kfacility $468professional $240

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$218.78
Median
$218.78
Typical High
$371.54
Aetna
Setting
Professional
Modifier
Global
Typical Low
$199.53
Median
$218.78
Typical High
$371.54
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$457.09
Median
$478.63
Typical High
$977.24
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$223.87
Median
$275.42
Typical High
$588.84
Aultcare
Setting
Professional
Modifier
Global
Typical Low
$389.05
Median
$389.05
Typical High
$389.05
CareSource
Setting
Facility
Modifier
Global
Typical Low
$223.87
Median
$380.19
Typical High
$537.03
CareSource
Setting
Professional
Modifier
Global
Typical Low
$288.40
Median
$398.11
Typical High
$602.56
Cigna
Setting
Facility
Modifier
Global
Typical Low
$288.40
Median
$288.40
Typical High
$316.23
Cigna
Setting
Professional
Modifier
Global
Typical Low
$208.93
Median
$208.93
Typical High
$316.23
Medical Mutual of Ohio
Setting
Facility
Modifier
Global
Typical Low
$288.40
Median
$288.40
Typical High
$302.00
Medical Mutual of Ohio
Setting
Professional
Modifier
Global
Typical Low
$208.93
Median
$208.93
Typical High
$223.87
Molina
Setting
Professional
Modifier
Global
Typical Low
$245.47
Median
$380.19
Typical High
$549.54
SummaCare
Setting
Professional
Modifier
Global
Typical Low
$457.09
Median
$512.86
Typical High
$933.25
United
Setting
Facility
Modifier
Global
Typical Low
$263.03
Median
$363.08
Typical High
$457.09
United
Setting
Professional
Modifier
Global
Typical Low
$147.91
Median
$223.87
Typical High
$309.03

Where Ohio sits

The same service costs 2.7 times more in Kansas than in Nebraska. Every bar is a state, most expensive first. Pick one to see its carriers and full range.

Ohio $257 · 27th of 51
KS $525NE $195

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.