go back

South Carolina rates for HCPCS L7403

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

Facilitymedian $295 · 10th–90th $200–$5620%10%20%10th90th$295Professionalmedian $224 · 10th–90th $186–$3630%10%20%10th90th$224$50.0$100.0$200.0$500.0$1.0K$2.0K

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
$199.53 / $199.53 / $199.53
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $223.87 / $331.13
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$275.42 / $446.68 / $524.81
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$288.40 / $288.40 / $316.23
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$208.93 / $208.93 / $512.86
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$223.87 / $223.87 / $223.87
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$199.53 / $323.59 / $707.95
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$128.82 / $128.82 / $128.82
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $302.00
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$263.03 / $295.12 / $537.03
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$165.96 / $218.78 / $302.00