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Oregon rates for HCPCS L7404

Addition To Upper Extremity Prosthesis Above Elbow Disarticulation Acrylic Material

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$292.26 / $398.32 / $1,889.59
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$434.07 / $434.07 / $434.07
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$316.87 / $316.87 / $434.07
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$458.44 / $1,269.86 / $1,656.23
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$398.32 / $558.25 / $654.91
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$486.95 / $615.62 / $687.67
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$519.85 / $654.91 / $720.41
Pacific Source
Facility/Professional
Professional
Modifier
Low / Median / High Price
$589.42 / $654.91 / $678.36
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$398.32 / $573.47 / $687.67
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$316.87 / $573.47 / $720.41
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$545.64 / $1,089.09 / $2,297.66
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$563.23 / $720.41 / $720.41
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$285.70 / $299.04 / $570.53