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 a/e acrylic
Edina, MN
See all hospitals reporting HCPCS L7404 →Price type
Fairview Health Services’s median price of $730 is 4% above the median hospital's median price ($701), higher than 74% of the 822 hospitals reporting HCPCS L7404. 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 | $303 | $303 | — | — | — | $303 – $303 |
| 2 | Bcbs Mn aware federal fee schedule · both | $623 | $623 | — | — | — | $623 – $623 |
| 3 | Bcbs Mn aware/blue plus fee schedule · both | $634 | $634 | — | — | — | $634 – $634 |
| 4 | Medica managed medicaid/accessability fee schedule · both | $655 | $655 | — | — | — | $655 – $655 |
| 5 | Sanford Health Plan medicare advantage fee schedule · outpatient | $660 | $660 | — | — | — | $660 – $660 |
| 6 | UnitedHealthcare medicare advantage fee schedule · outpatient | $660 | $660 | — | — | — | $660 – $660 |
| 7 | WellCare medicare advantage fee schedule · outpatient | $660 | $660 | — | — | — | $660 – $660 |
| 8 | Ucare medicare advantage/msho fee schedule · outpatient | $670 | $670 | — | — | — | $670 – $670 |
| 9 | Bcbs Mn medicare advantage fee schedule · outpatient | $687 | $687 | — | — | — | $687 – $687 |
| 10 | Medica medicare advantage non-snp fee schedule · outpatient | $700 | $700 | — | — | — | $700 – $700 |
| 11 | Ucare pmap fee schedule · outpatient | $706 | $706 | — | — | — | $706 – $706 |
| 12 | Medica medicare advantage non-snp fee schedule · both | $711 | $711 | — | — | — | $711 – $711 |
| 13 | Bcbs Mn pmap fee schedule · both | $714 | $714 | — | — | — | $714 – $714 |
| 14 | Bcbs Mn aware federal fee schedule · outpatient | $716 | $716 | — | — | — | $716 – $716 |
| 15 | Medica msho/medicare advantage snp fee schedule · both | $725 | $725 | — | — | — | $725 – $725 |
| 16 | Bcbs Mn aware/blue plus fee schedule · outpatient | $729 | $729 | — | — | — | $729 – $729 |
| 17 | Ucare pmap fee schedule · both | $731 | $731 | — | — | — | $731 – $731 |
| 18 | Medica managed medicaid/accessability fee schedule · outpatient | $806 | $806 | — | — | — | $806 – $806 |
| 19 | Medica msho/medicare advantage snp fee schedule · outpatient | $872 | $872 | — | — | — | $872 – $872 |
| 20 | Ucare individual and family with m health fairview fee schedule · outpatient | $1.2k | $1.2k | — | — | — | $1.2k – $1.2k |
| 21 | Medica bold fee schedule · both | $1.2k | $1.2k | — | — | — | $1.2k – $1.2k |
| 22 | UnitedHealthcare commercial fee schedule · both | $1.2k | $1.2k | — | — | — | $1.2k – $1.2k |
| 23 | UnitedHealthcare core fee schedule · both | $1.2k | $1.2k | — | — | — | $1.2k – $1.2k |
| 24 | Medica vantage self insured fee schedule · both | $1.3k | $1.3k | — | — | — | $1.3k – $1.3k |
| 25 | Medica city of st. paul/essential-uplan fee schedule · both | $1.4k | $1.4k | — | — | — | $1.4k – $1.4k |
Last updated: Feb 6, 2026
See Upper arm prosthesis addition, acrylic, above-elbow pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.