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Shoulder or Interscapular-Thoracic, Acrylic Material

Maine rates for HCPCS L7405

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

Rates data updated July 2026.

How much does Shoulder or Interscapular-Thoracic, Acrylic Material cost?

$575

Typical negotiated rate. In Maine, July 2026.

Insurers have agreed to pay about $575 for this service. The price depends on where it is billed: about $575 from a physician practice, and about $1,000 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 6 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$575$468 to $741
FacilityA hospital or hospital-owned outpatient department$1,000$631 to $1,023

How much rates vary

Facilitymedian $1,000 · 10th to 90th $589 to $1,148Professionalmedian $575 · 10th to 90th $372 to $741
$500$1K$2Kfacility $1,000professional $575

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$371.54
Median
$467.74
Typical High
$575.44
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$851.14
Median
$1,023.29
Typical High
$1,148.15
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$478.63
Median
$478.63
Typical High
$870.96
Cigna
Setting
Facility
Modifier
Global
Typical Low
$630.96
Median
$630.96
Typical High
$630.96
Cigna
Setting
Professional
Modifier
Global
Typical Low
$457.09
Median
$457.09
Typical High
$630.96
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$741.31
Median
$741.31
Typical High
$891.25
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$251.19
Median
$467.74
Typical High
$575.44
United
Setting
Facility
Modifier
Global
Typical Low
$251.19
Median
$512.86
Typical High
$616.60
United
Setting
Professional
Modifier
Global
Typical Low
$331.13
Median
$741.31
Typical High
$741.31

Where Maine sits

The same service costs 2.3 times more in Wisconsin than in Delaware. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Maine· 17th of 51

$575

WI $891DE $380

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.