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
Cedar Rapids, IA
See all hospitals reporting HCPCS L7404 →Price type
St Luke's Methodist Hospital’s median price of $701 is about the same as the median hospital's median price ($701), higher than 50% 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, 17 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 | UnitedHealthcare hmo fee schedule · both | $333 | $333 | — | — | — | $333 – $333 |
| 2 | UnitedHealthcare ppo fee schedule · both | $333 | $333 | — | — | — | $333 – $333 |
| 3 | Wellmark commercial fee schedule · both | $654 | $654 | — | — | — | $654 – $654 |
| 4 | Wellmark hmo fee schedule · both | $654 | $654 | — | — | — | $654 – $654 |
| 5 | Wellmark ppo fee schedule · both | $654 | $654 | — | — | — | $654 – $654 |
| 6 | Aetna medicare advantage case rate · outpatient | $681 | $681 | — | — | — | $681 – $681 |
| 7 | Molina medicare advantage case rate · outpatient | $681 | $681 | — | — | — | $681 – $681 |
| 8 | Wellmark medicare advantage case rate · outpatient | $681 | $681 | — | — | — | $681 – $681 |
| 9 | Humana medicare advantage case rate · outpatient | $701 | $701 | — | — | — | $701 – $701 |
| 10 | UnitedHealthcare medicare advantage case rate · outpatient | $701 | $701 | — | — | — | $701 – $701 |
| 11 | Aetna hmo fee schedule · both | $746 | $746 | — | — | — | $746 – $746 |
| 12 | Aetna ppo fee schedule · both | $746 | $746 | — | — | — | $746 – $746 |
| 13 | Cigna commercial fee schedule · both | $848 | $848 | — | — | — | $848 – $848 |
| 14 | UnitedHealthcare hmo fee schedule · outpatient | $959 | $959 | — | — | — | $959 – $959 |
| 15 | UnitedHealthcare ppo fee schedule · outpatient | $959 | $959 | — | — | — | $959 – $959 |
| 16 | Aetna hmo fee schedule · outpatient | $1.2k | $1.2k | — | — | — | $1.2k – $1.2k |
| 17 | Aetna ppo fee schedule · outpatient | $1.2k | $1.2k | — | — | — | $1.2k – $1.2k |
Last updated: Jan 28, 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.