Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.
Original text from hospital filings
Add UE prost b/e acrylic
Edina, MN
See all hospitals reporting HCPCS L7403 →Price type
Fairview Health Services’s median price of $484 is 4% above the median hospital's median price ($465), higher than 73% of the 826 hospitals reporting HCPCS L7403. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 6 payers, 33 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.
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| # | |||||||
|---|---|---|---|---|---|---|---|
| 1 | Bcbs Mn pmap fee schedule · outpatient | $201 | $201 | — | — | — | $201 – $201 |
| 2 | Bcbs Mn aware federal fee schedule · both | $412 | $412 | — | — | — | $412 – $412 |
| 3 | Bcbs Mn aware/blue plus fee schedule · both | $420 | $420 | — | — | — | $420 – $420 |
| 4 | Medica managed medicaid/accessability fee schedule · both | $434 | $434 | — | — | — | $434 – $434 |
| 5 | Sanford Health Plan medicare advantage fee schedule · outpatient | $437 | $437 | — | — | — | $437 – $437 |
| 6 | UnitedHealthcare medicare advantage fee schedule · outpatient | $437 | $437 | — | — | — | $437 – $437 |
| 7 | WellCare medicare advantage fee schedule · outpatient | $437 | $437 | — | — | — | $437 – $437 |
| 8 | Ucare medicare advantage/msho fee schedule · outpatient | $444 | $444 | — | — | — | $444 – $444 |
| 9 | Bcbs Mn medicare advantage fee schedule · outpatient | $455 | $455 | — | — | — | $455 – $455 |
| 10 | Medica medicare advantage non-snp fee schedule · outpatient | $464 | $464 | — | — | — | $464 – $464 |
| 11 | Ucare pmap fee schedule · outpatient | $468 | $468 | — | — | — | $468 – $468 |
| 12 | Medica medicare advantage non-snp fee schedule · both | $471 | $471 | — | — | — | $471 – $471 |
| 13 | Bcbs Mn pmap fee schedule · both | $473 | $473 | — | — | — | $473 – $473 |
| 14 | Bcbs Mn aware federal fee schedule · outpatient | $475 | $475 | — | — | — | $475 – $475 |
| 15 | Medica msho/medicare advantage snp fee schedule · both | $480 | $480 | — | — | — | $480 – $480 |
| 16 | Bcbs Mn aware/blue plus fee schedule · outpatient | $483 | $483 | — | — | — | $483 – $483 |
| 17 | Ucare pmap fee schedule · both | $484 | $484 | — | — | — | $484 – $484 |
| 18 | Medica managed medicaid/accessability fee schedule · outpatient | $534 | $534 | — | — | — | $534 – $534 |
| 19 | Medica msho/medicare advantage snp fee schedule · outpatient | $577 | $577 | — | — | — | $577 – $577 |
| 20 | Ucare individual and family with m health fairview fee schedule · outpatient | $778 | $778 | — | — | — | $778 – $778 |
| 21 | Medica bold fee schedule · both | $819 | $819 | — | — | — | $819 – $819 |
| 22 | UnitedHealthcare commercial fee schedule · both | $825 | $825 | — | — | — | $825 – $825 |
| 23 | UnitedHealthcare core fee schedule · both | $825 | $825 | — | — | — | $825 – $825 |
| 24 | Medica vantage self insured fee schedule · both | $887 | $887 | — | — | — | $887 – $887 |
| 25 | Medica city of st. paul/essential-uplan fee schedule · both | $910 | $910 | — | — | — | $910 – $910 |
Last updated: Feb 6, 2026
See Below-elbow prosthesis add-on, acrylic material pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.