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Iowa rates for HCPCS L7404

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

Facilitymedian $661 · 10th–90th $437$1,8200%10%20%10th90th$661Professionalmedian $380 · 10th–90th $282$7080%20%10th90th$380$0.5$2.0$10.0$50.0$200.0$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$489.78
Median
$524.81
Typical High
$562.34
Aetna
Setting
Professional
Modifier
Global
Typical Low
$281.84
Median
$346.74
Typical High
$562.34
Cigna
Setting
Facility
Modifier
Global
Typical Low
$436.52
Median
$436.52
Typical High
$741.31
Cigna
Setting
Professional
Modifier
Global
Typical Low
$436.52
Median
$776.25
Typical High
$977.24
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$630.96
Median
$707.95
Typical High
$851.14
Medica
Setting
Facility
Modifier
Global
Typical Low
$457.09
Median
$870.96
Typical High
$3,090.30
Medica
Setting
Professional
Modifier
Global
Typical Low
$316.23
Median
$446.68
Typical High
$1,122.02
Midlands
Setting
Professional
Modifier
Global
Typical Low
$724.44
Median
$758.58
Typical High
$912.01
Midlands
Setting
Facility
Modifier
Global
Typical Low
$741.31
Median
$741.31
Typical High
$741.31
Midlands
Setting
Professional
Modifier
Global
Typical Low
$691.83
Median
$1,122.02
Typical High
$1,122.02
United
Setting
Facility
Modifier
Global
Typical Low
$295.12
Median
$676.08
Typical High
$1,584.89
United
Setting
Professional
Modifier
Global
Typical Low
$309.03
Median
$354.81
Typical High
$630.96
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$512.86
Median
$660.69
Typical High
$660.69