HCPCS L7404
Addition to upper extremity prosthesis, above elbow disarticulation, acrylic material
Current code24 hospitals with prices
What Washington hospitals publish for this code
Commercial insurance: Rate negotiated with a private insurer or employer plan, including exchange and public-option plans.
| Hospital | Commercial insurance rates (lowest – highest) | Cash price | List price (before discounts) |
|---|---|---|---|
| Capital Medical Center | $576 – $4,467 | — | — |
| Deaconess Medical Center | $799 – $2,780 | — | — |
| Harborview Medical Center | $1,069 – $1,336 | $814 – $818 | $1,162 – $1,169 |
| Kadlec Regional Medical Center | $1,007 – $1,876 | — | — |
| Mary Bridge Children's Hospital | $576 – $4,903 | — | — |
| MultiCare Auburn Medical Center | $560 – $2,886 | — | — |
| MultiCare Covington Medical Center | $560 – $2,886 | — | — |
| MultiCare Good Samaritan Hospital | $649 – $2,886 | — | — |
| MultiCare Valley Hospital | $640 – $2,774 | — | — |
| Overlake Hospital Medical Center & Clinics | $613 – $1,838 | — | — |
| Prov Sacred HRT Med Ctr & Childs Hosp. | $1,035 – $2,216 | — | — |
| Providence Centralia Hospital | $1,129 – $2,498 | — | — |
| Providence Regional Medical Center Everett | $802 – $1,550 | — | — |
| Providence St Peter Hospital | $568 – $2,181 | — | — |
| Seattle Children's Hospital | $550 – $979 | $1,019 | $1,019 |
| Swedish Edmonds Hospital | $1,002 – $2,450 | — | — |
| Swedish Issaquah | $1,002 – $1,483 | — | — |
| Swedish Medical Center | $1,002 – $2,386 | — | — |
| Swedish Medical Center / Cherry Hill | $1,002 – $2,386 | — | — |
| Tacoma General Allenmore Hospital | $560 – $2,886 | — | — |
| University of Washington Medical Ctr | $1,069 – $2,095 | $1,034 | $1,477 |
| Virginia Mason Medical Center | $640 – $2,323 | — | — |
| Wellfound Behavioral Health Hospital | $1,686 | — | — |
| Yakima Valley Memorial | $576 – $1,733 | — | — |
Medicare (traditional) reference
Only for people on original Medicare. These are CMS’s 2026 amounts. They aren’t what private insurance or cash patients pay.
- Equipment fee, Washington
- $668 (fee)