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Tennessee rates for HCPCS A5114

Leg strap; foam or fabric, replacement only, per set

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.49 / $5.49 / $6.82
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.45 / $6.73 / $9.31
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.34 / $9.57 / $9.57
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.95 / $7.51 / $7.51
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.38 / $6.38 / $8.50
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$28.30 / $80.00 / $80.00
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$108.14 / $110.75 / $110.75
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.54 / $5.14 / $7.60