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Oklahoma rates for HCPCS L7404

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

Facilitymedian $380 · 10th–90th $288–$9770%20%10th90th$380Professionalmedian $331 · 10th–90th $288–$5890%10%20%10th90th$331$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
$288.40 / $288.40 / $288.40
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$288.40 / $331.13 / $501.19
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$398.11 / $588.84 / $588.84
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 / $724.44
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$288.40 / $426.58 / $2,089.30
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$199.53 / $331.13 / $831.76
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$269.15 / $446.68 / $691.83
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$199.53 / $302.00 / $446.68