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West Virginia rates for HCPCS L7403

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

Facilitymedian $214 · 10th–90th $214–$6030%50%90th$214Professionalmedian $214 · 10th–90th $195–$3090%20%40%10th90th$214$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$213.80 / $213.80 / $213.80
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$194.98 / $213.80 / $229.09
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$288.40 / $288.40 / $602.56
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$316.23 / $316.23 / $537.03
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$288.40 / $707.95 / $707.95
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$208.93 / $208.93 / $2,137.96
Highmark BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$302.00 / $302.00 / $302.00
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$263.03 / $275.42 / $457.09
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$204.17 / $263.03 / $363.08