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Montana rates for HCPCS L7405

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

Facilitymedian $871 · 10th–90th $617–$1,0720%20%10th90th$871Professionalmedian $562 · 10th–90th $275–$1,0720%10%10th90th$562$100.0$200.0$500.0$1.0K$2.0K

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
Professional
Modifier
Typical Low / Median / Typical High
$275.42 / $524.81 / $776.25
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$630.96 / $933.25 / $933.25
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$630.96 / $933.25 / $933.25
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$676.08 / $870.96 / $1,698.24
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$676.08 / $870.96 / $1,698.24
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$416.87 / $831.76 / $1,258.93
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $691.83 / $933.25
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$512.86 / $588.84 / $616.60
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$354.81 / $389.05 / $602.56