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Arizona rates for HCPCS L7404

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

Facilitymedian $537 · 10th–90th $195–$1,2880%10%10th90th$537Professionalmedian $347 · 10th–90th $282–$6030%20%10th90th$347$0.5$2.0$10.0$50.0$200.0$1.0K$5.0K

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
Professional
Modifier
Typical Low / Median / Typical High
$288.40 / $346.74 / $588.84
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$173.78 / $707.95 / $1,348.96
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$501.19 / $645.65 / $1,258.93
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$436.52 / $436.52 / $436.52
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$316.23 / $316.23 / $436.52
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$194.98 / $436.52 / $1,348.96
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $302.00 / $3,388.44
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$398.11 / $537.03 / $537.03
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$234.42 / $302.00 / $446.68