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Wisconsin rates for HCPCS L7405

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

Facilitymedian $891 · 10th–90th $794$1,6220%50%10th90th$891Professionalmedian $646 · 10th–90th $389$1,3490%20%10th90th$646$1.0$5.0$20.0$100.0$500.0$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$446.68 / $446.68 / $446.68
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$380.19 / $446.68 / $741.31
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$891.25 / $891.25 / $1,479.11
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$812.83 / $831.76 / $1,000.00
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$630.96 / $2,041.74 / $4,365.16
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$457.09 / $1,258.93 / $1,698.24
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$436.52 / $724.44 / $1,096.48
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$501.19 / $851.14 / $1,071.52
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$446.68 / $870.96 / $4,073.80
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$398.11 / $562.34 / $1,000.00
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $64.57 / $85.11
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,412.54 / $1,412.54 / $1,412.54
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$630.96 / $1,000.00 / $1,737.80
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$891.25 / $1,348.96 / $2,454.71
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$630.96 / $1,778.28 / $4,073.80
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$457.09 / $912.01 / $4,466.84
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$467.74 / $588.84 / $891.25
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$338.84 / $436.52 / $724.44