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New Hampshire rates for HCPCS L7404

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

Facilitymedian $661 · 10th–90th $372$7940%10%20%10th90th$661Professionalmedian $447 · 10th–90th $302$6030%20%10th90th$447$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
Setting
Facility
Modifier
Global
Typical Low
$371.54
Median
$371.54
Typical High
$446.68
Aetna
Setting
Professional
Modifier
Global
Typical Low
$281.84
Median
$371.54
Typical High
$549.54
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$660.69
Median
$707.95
Typical High
$812.83
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$407.38
Median
$407.38
Typical High
$416.87
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
$1,047.13
United
Setting
Facility
Modifier
Global
Typical Low
$186.21
Median
$407.38
Typical High
$446.68
United
Setting
Professional
Modifier
Global
Typical Low
$275.42
Median
$446.68
Typical High
$575.44
Well Sense
Setting
Facility
Modifier
Global
Typical Low
$630.96
Median
$630.96
Typical High
$933.25