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North Carolina rates for HCPCS L7404

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

Facilitymedian $501 · 10th–90th $295$1,2300%20%10th90th$501Professionalmedian $447 · 10th–90th $288$5130%20%40%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
$501.19
Median
$501.19
Typical High
$501.19
Aetna
Setting
Professional
Modifier
Global
Typical Low
$288.40
Median
$407.38
Typical High
$501.19
BCBS
Setting
Facility
Modifier
Global
Typical Low
$562.34
Median
$562.34
Typical High
$676.08
BCBS
Setting
Professional
Modifier
Global
Typical Low
$512.86
Median
$512.86
Typical High
$562.34
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
Medcost
Setting
Professional
Modifier
Global
Typical Low
$316.23
Median
$338.84
Typical High
$446.68
Medcost
Setting
Facility
Modifier
Global
Typical Low
$281.84
Median
$549.54
Typical High
$1,000.00
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$0.60
Median
$0.60
Typical High
$0.60
United
Setting
Facility
Modifier
Global
Typical Low
$251.19
Median
$446.68
Typical High
$549.54
United
Setting
Professional
Modifier
Global
Typical Low
$263.03
Median
$338.84
Typical High
$478.63
Wellcare
Setting
Facility
Modifier
Global
Typical Low
$3,162.28
Median
$3,162.28
Typical High
$3,162.28
Wellcare
Setting
Professional
Modifier
Global
Typical Low
$3,467.37
Median
$3,467.37
Typical High
$4,897.79