go back

Massachusetts rates for HCPCS L7404

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

Facilitymedian $347 · 10th–90th $288$2,9510%20%40%10th90th$347Professionalmedian $447 · 10th–90th $288$6460%20%10th90th$447$0.5$5.0$50.0$500.0$5.0K$50.0K

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
$288.40
Median
$288.40
Typical High
$288.40
Aetna
Setting
Professional
Modifier
Global
Typical Low
$281.84
Median
$331.13
Typical High
$588.84
AllWays Health Partners
Setting
Facility
Modifier
Global
Typical Low
$616.60
Median
$645.65
Typical High
$3,162.28
AllWays Health Partners
Setting
Professional
Modifier
Global
Typical Low
$302.00
Median
$512.86
Typical High
$741.31
Cigna
Setting
Facility
Modifier
Global
Typical Low
$436.52
Median
$436.52
Typical High
$436.52
Cigna
Setting
Professional
Modifier
Global
Typical Low
$316.23
Median
$316.23
Typical High
$467.74
Fallon Health
Setting
Facility
Modifier
Global
Typical Low
$60.26
Median
$3,630.78
Typical High
$9,772.37
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$575.44
Median
$575.44
Typical High
$870.96
Health New England
Setting
Professional
Modifier
Global
Typical Low
$501.19
Median
$501.19
Typical High
$501.19
Mass General Brigham
Setting
Facility
Modifier
Global
Typical Low
$616.60
Median
$645.65
Typical High
$3,162.28
Mass General Brigham
Setting
Professional
Modifier
Global
Typical Low
$302.00
Median
$512.86
Typical High
$741.31
United
Setting
Facility
Modifier
Global
Typical Low
$190.55
Median
$446.68
Typical High
$812.83
United
Setting
Professional
Modifier
Global
Typical Low
$295.12
Median
$457.09
Typical High
$575.44