go back

Shoulder or Interscapular-Thoracic, Acrylic Material

New York 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?

$479

Typical negotiated rate. In New York, July 2026.

Insurers have agreed to pay about $479 for this service. The price depends on where it is billed: about $479 from a physician practice, and about $603 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 9 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$479$427 to $692
FacilityA hospital or hospital-owned outpatient department$603$513 to $891

How much rates vary

Facilitymedian $603 · 10th to 90th $372 to $1,318Professionalmedian $479 · 10th to 90th $372 to $1,259
$500$1K$2K$5K$10K$20K$50Kfacility $603professional $479

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. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$316.23
Median
$416.87
Typical High
$977.24
Aetna
Setting
Professional
Modifier
Global
Typical Low
$316.23
Median
$416.87
Typical High
$575.44
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$870.96
Median
$870.96
Typical High
$1,737.80
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$478.63
Median
$478.63
Typical High
$1,479.11
CDPHP
Setting
Facility
Modifier
Global
Typical Low
$660.69
Median
$707.95
Typical High
$707.95
CDPHP
Setting
Professional
Modifier
Global
Typical Low
$707.95
Median
$707.95
Typical High
$707.95
Cigna
Setting
Facility
Modifier
Global
Typical Low
$630.96
Median
$630.96
Typical High
$1,230.27
Cigna
Setting
Professional
Modifier
Global
Typical Low
$457.09
Median
$457.09
Typical High
$660.69
Emblem Health
Setting
Facility
Modifier
Global
Typical Low
$870.96
Median
$1,445.44
Typical High
$3,388.44
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$537.03
Median
$912.01
Typical High
$1,659.59
Excellus BCBS
Setting
Facility
Modifier
Global
Typical Low
$602.56
Median
$602.56
Typical High
$630.96
Excellus BCBS
Setting
Professional
Modifier
Global
Typical Low
$512.86
Median
$549.54
Typical High
$602.56
MVP Health Care
Setting
Facility
Modifier
Global
Typical Low
$1,288.25
Median
$50,118.72
Typical High
$75,857.76
MVP Health Care
Setting
Professional
Modifier
Global
Typical Low
$524.81
Median
$831.76
Typical High
$977.24
United
Setting
Facility
Modifier
Global
Typical Low
$331.13
Median
$602.56
Typical High
$1,380.38
United
Setting
Professional
Modifier
Global
Typical Low
$295.12
Median
$575.44
Typical High
$1,412.54
Univera
Setting
Facility
Modifier
Global
Typical Low
$489.78
Median
$512.86
Typical High
$630.96
Univera
Setting
Professional
Modifier
Global
Typical Low
$512.86
Median
$549.54
Typical High
$602.56

Where New York 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.

New York· 30th of 51

$479

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.