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Utah rates for HCPCS L7405

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

Facilitymedian $589 · 10th–90th $251–$8910%20%40%10th90th$589Professionalmedian $631 · 10th–90th $251–$3,7150%10%10th90th$631$50.0$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$251.19 / $251.19 / $251.19
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$251.19 / $467.74 / $3,715.35
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$630.96 / $630.96 / $630.96
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$457.09 / $457.09 / $630.96
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $645.65 / $831.76
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$851.14 / $891.25 / $891.25
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$616.60 / $630.96 / $954.99
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$851.14 / $891.25 / $912.01
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$630.96 / $912.01 / $1,047.13
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$323.59 / $512.86 / $588.84
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$309.03 / $389.05 / $660.69