go back

Missouri rates for HCPCS L7405

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$398.11 / $588.84 / $588.84
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$371.54 / $467.74 / $1,258.93
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$891.25 / $891.25 / $3,090.30
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$467.74 / $478.63 / $812.83
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$537.03 / $537.03 / $891.25
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 / $630.96
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$436.52 / $707.95 / $1,949.84
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$309.03 / $436.52 / $4,466.84
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$512.86 / $691.83 / $831.76
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$309.03 / $436.52 / $616.60