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Tennessee rates for HCPCS L7403

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

Facilitymedian $316 · 10th–90th $191–$2,0890%20%10th90th$316Professionalmedian $214 · 10th–90th $191–$3720%20%10th90th$214$0.5$2.0$10.0$50.0$200.0$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
$190.55 / $190.55 / $338.84
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$190.55 / $213.80 / $371.54
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$338.84 / $338.84 / $363.08
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$288.40 / $288.40 / $331.13
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$208.93 / $208.93 / $288.40
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,089.30 / $2,089.30 / $2,089.30
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,290.87 / $3,235.94 / $3,235.94
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$234.42 / $295.12 / $316.23
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $218.78 / $302.00