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Florida 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
$288.40 / $309.03 / $354.81
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$288.40 / $346.74 / $501.19
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$436.52 / $436.52 / $501.19
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$316.23 / $316.23 / $436.52
Florida Blue
Facility/Professional
Professional
Modifier
Low / Median / High Price
$151.36 / $416.87 / $691.83
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$537.03 / $537.03 / $549.54
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$269.15 / $446.68 / $676.08
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$288.40 / $331.13 / $446.68
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$407.38 / $407.38 / $691.83