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Nebraska rates for HCPCS L7404

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

Facilitymedian $676 · 10th–90th $398$3,0900%10%20%10th90th$676Professionalmedian $427 · 10th–90th $240$1,7780%10%20%10th90th$427$200.0$500.0$1.0K$2.0K

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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$426.58 / $426.58 / $426.58
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$194.98 / $426.58 / $2,818.38
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$588.84 / $645.65 / $645.65
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$436.52 / $436.52 / $741.31
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$436.52 / $776.25 / $1,148.15
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$426.58 / $724.44 / $3,090.30
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$223.87 / $398.11 / $660.69
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$724.44 / $741.31 / $1,778.28
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$741.31 / $741.31 / $741.31
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$933.25 / $1,659.59 / $1,778.28
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$398.11 / $457.09 / $691.83
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$239.88 / $331.13 / $524.81