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North Dakota 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
$645.44 / $645.44 / $645.44
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$645.44 / $735.01 / $735.01
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$829.49 / $980.75 / $1,005.15
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,017.38 / $1,027.55 / $1,292.07
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$260.05 / $645.44 / $4,086.48
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$353.43 / $586.65 / $717.45
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$260.73 / $442.59 / $706.85