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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
$349.08 / $349.08 / $349.08
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$349.08 / $349.08 / $349.08
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$398.41 / $398.41 / $447.70
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$316.87 / $316.87 / $316.87
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$425.70 / $425.70 / $1,300.05
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$217.82 / $326.73 / $420.32