go back

Tennessee rates for HCPCS L7404

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

Facilitymedian $479 · 10th–90th $288–$3,1620%20%10th90th$479Professionalmedian $324 · 10th–90th $288–$5620%20%10th90th$324$0.5$2.0$10.0$50.0$200.0$1.0K$5.0K

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 / $512.86
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$288.40 / $323.59 / $562.34
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$512.86 / $512.86 / $549.54
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$436.52 / $436.52 / $501.19
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$316.23 / $316.23 / $436.52
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,162.28 / $3,162.28 / $3,162.28
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,467.37 / $4,897.79 / $4,897.79
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$354.81 / $446.68 / $478.63
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$223.87 / $323.59 / $457.09