go back

Tennessee 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
$371.54 / $371.54 / $676.08
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$371.54 / $416.87 / $741.31
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$660.69 / $660.69 / $707.95
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
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,073.80 / $4,073.80 / $4,073.80
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,466.84 / $6,456.54 / $6,456.54
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$302.00 / $512.86 / $616.60
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$295.12 / $426.58 / $602.56