go back

Hawaii rates for HCPCS L7404

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

Facilitymedian $437 · 10th–90th $398–$5250%50%10th90th$437Professionalmedian $398 · 10th–90th $282–$6610%20%10th90th$398$500.0$1.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$281.84 / $354.81 / $562.34
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$436.52 / $436.52 / $524.81
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$436.52 / $616.60 / $831.76
HMSA
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$660.69 / $660.69 / $660.69
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$398.11 / $660.69 / $776.25
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$398.11 / $407.38 / $478.63
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$354.81 / $457.09 / $724.44