go back

Texas rates for HCPCS L7404

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

Facilitymedian $550 · 10th–90th $295$1,4790%10%20%10th90th$550Professionalmedian $324 · 10th–90th $288$5620%20%40%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
$295.12 / $295.12 / $316.23
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$288.40 / $331.13 / $588.84
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$323.59 / $323.59 / $323.59
Christus
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$79.43 / $691.83 / $691.83
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 / $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
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$295.12 / $588.84 / $912.01
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$295.12 / $331.13 / $660.69
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$501.19 / $501.19 / $512.86
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$295.12 / $549.54 / $912.01
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$316.23 / $316.23 / $436.52
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$269.15 / $478.63 / $691.83
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$251.19 / $371.54 / $457.09
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$363.08 / $691.83 / $691.83