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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 July 2026.

How much does Above Elbow Disarticulation, Acrylic Material cost?

$437

Typical negotiated rate. In Maine, July 2026.

Insurers have agreed to pay about $437 for this service. The price depends on where it is billed: about $417 from a physician practice, and about $776 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

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.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$417$363 to $575
FacilityA hospital or hospital-owned outpatient department$776$479 to $776

How much rates vary

Facilitymedian $776 · 10th to 90th $437 to $891Professionalmedian $417 · 10th to 90th $288 to $575
$200.0$500.0$1.0K$2.0Kfacility $776professional $417

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$288.40
Median
$363.08
Typical High
$436.52
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$645.65
Median
$776.25
Typical High
$891.25
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$407.38
Median
$407.38
Typical High
$660.69
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
$436.52
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$575.44
Median
$575.44
Typical High
$691.83
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$194.98
Median
$363.08
Typical High
$436.52
United
Setting
Facility
Modifier
Global
Typical Low
$190.55
Median
$398.11
Typical High
$478.63
United
Setting
Professional
Modifier
Global
Typical Low
$257.04
Median
$562.34
Typical High
$575.44

Where Maine sits

The same service costs 2.3 times more in Wisconsin than in Nebraska. Every bar is a state, most expensive first. Pick one to see its carriers and full range.

Maine $437 · 18th of 51
WI $676NE $295

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.