go back

Alaska rates for HCPCS L7405

Addition to upper extremity prosthesis, shoulder disarticulation/interscapular thoracic, acrylic material

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$467.74 / $524.81 / $758.58
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$630.96 / $630.96 / $630.96
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$457.09 / $457.09 / $660.69
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$251.19 / $758.58 / $831.76
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$630.96 / $870.96 / $2,818.38
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$758.58 / $831.76 / $870.96
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$676.08 / $831.76 / $851.14
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$251.19 / $251.19 / $870.96
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.26 / $630.96 / $812.83
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$512.86 / $512.86 / $588.84
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$416.87 / $426.58 / $1,905.46