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New Mexico rates for HCPCS L7404

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

Facilitymedian $457 · 10th–90th $195–$6920%10%10th90th$457Professionalmedian $363 · 10th–90th $295–$5890%10%20%10th90th$363$100.0$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
$371.54 / $371.54 / $371.54
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$295.12 / $363.08 / $588.84
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$407.38 / $537.03 / $616.60
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$436.52 / $436.52 / $436.52
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$316.23 / $316.23 / $831.76
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$537.03 / $676.08 / $1,023.29
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$194.98 / $478.63 / $691.83
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$316.23 / $316.23 / $691.83
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$398.11 / $457.09 / $812.83
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $302.00 / $446.68