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North Dakota rates for HCPCS L7404

Addition To Upper Extremity Prosthesis Above Elbow Disarticulation Acrylic Material

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$493.54 / $493.54 / $493.54
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$493.54 / $562.04 / $562.04
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$634.27 / $749.93 / $768.59
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$777.75 / $785.53 / $987.74
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$198.84 / $493.54 / $3,124.60
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$270.25 / $448.56 / $548.60
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$199.36 / $448.56 / $540.49