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Shoulder or Interscapular-Thoracic, Acrylic Material

Ohio 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 Ohio, July 2026.

Insurers have agreed to pay about $479 for this service. The price depends on where it is billed: about $468 from a physician practice, and about $912 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 8 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$468$427 to $631
FacilityA hospital or hospital-owned outpatient department$912$724 to $1,047

How much rates vary

Facilitymedian $912 · 10th to 90th $437 to $1,514Professionalmedian $468 · 10th to 90th $407 to $933
$500$1K$2Kfacility $912professional $468

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
$426.58
Median
$426.58
Typical High
$724.44
Aetna
Setting
Professional
Modifier
Global
Typical Low
$398.11
Median
$426.58
Typical High
$741.31
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$891.25
Median
$954.99
Typical High
$1,905.46
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$436.52
Median
$537.03
Typical High
$1,174.90
CareSource
Setting
Facility
Modifier
Global
Typical Low
$436.52
Median
$758.58
Typical High
$1,047.13
CareSource
Setting
Professional
Modifier
Global
Typical Low
$575.44
Median
$794.33
Typical High
$1,202.26
Cigna
Setting
Facility
Modifier
Global
Typical Low
$630.96
Median
$630.96
Typical High
$691.83
Cigna
Setting
Professional
Modifier
Global
Typical Low
$457.09
Median
$457.09
Typical High
$691.83
Medical Mutual of Ohio
Setting
Facility
Modifier
Global
Typical Low
$630.96
Median
$630.96
Typical High
$660.69
Medical Mutual of Ohio
Setting
Professional
Modifier
Global
Typical Low
$457.09
Median
$457.09
Typical High
$457.09
Molina
Setting
Professional
Modifier
Global
Typical Low
$478.63
Median
$758.58
Typical High
$1,096.48
SummaCare
Setting
Professional
Modifier
Global
Typical Low
$891.25
Median
$1,000.00
Typical High
$1,862.09
United
Setting
Facility
Modifier
Global
Typical Low
$512.86
Median
$707.95
Typical High
$912.01
United
Setting
Professional
Modifier
Global
Typical Low
$295.12
Median
$436.52
Typical High
$616.60

Where Ohio 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.

Ohio· 28th 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.