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Nationwide rates for HCPCS L7404

Addition to upper extremity prosthesis, above elbow disarticulation, acrylic material

Facilitymedian $501 · 10th–90th $288–$1,5140%10%10th90th$501Professionalmedian $372 · 10th–90th $288–$6760%20%10th90th$372$0.5$5.0$50.0$500.0$5.0K$50.0K$500.0K

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
$288.40 / $346.74 / $588.84
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$288.40 / $346.74 / $562.34
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$275.42 / $371.54 / $1,380.38
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$354.81 / $416.87 / $812.83
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$436.52 / $436.52 / $2,754.23
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$316.23 / $316.23 / $977.24
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$338.84 / $457.09 / $812.83
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$251.19 / $338.84 / $588.84

See more rates by state

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