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Texas rates for HCPCS L7403

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

Facilitymedian $363 · 10th–90th $195–$9770%10%20%10th90th$363Professionalmedian $214 · 10th–90th $191–$3890%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
$194.98 / $194.98 / $208.93
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$190.55 / $218.78 / $389.05
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $213.80 / $346.74
Christus
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$79.43 / $457.09 / $457.09
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 / $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
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$194.98 / $389.05 / $602.56
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$194.98 / $218.78 / $436.52
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$338.84 / $338.84 / $338.84
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$194.98 / $363.08 / $602.56
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$208.93 / $208.93 / $288.40
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$177.83 / $316.23 / $457.09
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$165.96 / $245.47 / $302.00
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$239.88 / $457.09 / $457.09