go back

Washington, DC 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
$346.74 / $346.74 / $346.74
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$288.40 / $323.59 / $436.52
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$398.11 / $398.11 / $457.09
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$436.52 / $436.52 / $436.52
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$316.23 / $316.23 / $467.74
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$436.52 / $933.25 / $1,288.25
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$977.24 / $977.24 / $977.24
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$218.78 / $323.59 / $501.19