go back

New York rates for HCPCS L7404

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

Facilitymedian $525 · 10th–90th $282$1,2020%20%10th90th$525Professionalmedian $407 · 10th–90th $288$9120%20%10th90th$407$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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$239.88 / $524.81 / $741.31
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$257.04 / $331.13 / $524.81
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$660.69 / $660.69 / $1,348.96
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$407.38 / $416.87 / $1,047.13
CDPHP
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$512.86 / $549.54 / $549.54
CDPHP
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$549.54 / $549.54 / $549.54
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$436.52 / $436.52 / $53,703.18
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$316.23 / $316.23 / $776.25
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$660.69 / $1,096.48 / $2,570.40
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$416.87 / $660.69 / $1,258.93
Excellus BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$467.74 / $467.74 / $489.78
Excellus BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$398.11 / $416.87 / $467.74
MVP Health Care
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,000.00 / $50,118.72 / $75,857.76
MVP Health Care
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$436.52 / $645.65 / $645.65
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$251.19 / $446.68 / $1,819.70
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$251.19 / $436.52 / $1,096.48
Univera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$371.54 / $398.11 / $489.78
Univera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$398.11 / $416.87 / $467.74