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Above Elbow Disarticulation, Acrylic Material

Maine rates for HCPCS L7404

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

Rates data updated October 2026.

How much does Above Elbow Disarticulation, Acrylic Material cost?

$417

Typical negotiated rate. In Maine, October 2026.

Insurers have agreed to pay about $417 for this service. Most negotiated rates run $407 to $575.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 6 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $832 · 10th to 90th $646 to $1,585Professionalmedian $407 · 10th to 90th $309 to $575
$200$500$1Kfacility $832professional $407

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
None
Typical Low
$338.84
Median
$436.52
Typical High
$436.52
Anthem BCBS
Setting
Facility
Modifier
None
Typical Low
$645.65
Median
$831.76
Typical High
$1,584.89
Anthem BCBS
Setting
Professional
Modifier
None
Typical Low
$407.38
Median
$407.38
Typical High
$446.68
Anthem BCBS
Setting
Professional
Modifier
RR · Rental
Typical Low
$40.74
Median
$40.74
Typical High
$44.67
Anthem BCBS
Setting
Professional
Modifier
UE · Used equipment
Typical Low
$302.00
Median
$302.00
Typical High
$331.13
Cigna
Setting
Facility
Modifier
None
Typical Low
$436.52
Median
$436.52
Typical High
$478.63
Cigna
Setting
Professional
Modifier
None
Typical Low
$316.23
Median
$316.23
Typical High
$436.52
Harvard Pilgrim
Setting
Professional
Modifier
None
Typical Low
$257.04
Median
$575.44
Typical High
$758.58
Martin's Point
Setting
Professional
Modifier
None
Typical Low
$338.84
Median
$436.52
Typical High
$436.52
United
Setting
Professional
Modifier
None
Typical Low
$257.04
Median
$323.59
Typical High
$912.01

Where Maine sits

The same service costs 2.2 times more in Montana than in Delaware. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Maine· 28th of 51

$417

MT $708DE $316

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.