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Connecticut rates for HCPCS L7404

Addition To Upper Extremity Prosthesis Above Elbow Disarticulation Acrylic Material

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$318.31 / $318.31 / $318.31
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$285.00 / $295.33 / $318.95
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$507.56 / $654.91 / $749.29
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$382.51 / $403.13 / $403.13
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$434.07 / $434.07 / $434.07
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$316.87 / $316.87 / $434.07
ConnectiCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$425.70 / $425.70 / $425.70
ConnectiCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$425.70 / $425.70 / $602.53
Health New England
Facility/Professional
Professional
Modifier
Low / Median / High Price
$498.68 / $498.68 / $498.68
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$249.34 / $326.73 / $460.81