go back

Tennessee rates for HCPCS L1755

Legg Perthes orthosis, (Patten bottom type), custom fabricated

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$836.03 / $836.03 / $913.44
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$820.55 / $851.52 / $1,564.80
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,107.17 / $1,672.44 / $1,672.44
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$953.44 / $1,395.53 / $1,395.53
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,018.74 / $1,018.74 / $1,395.53
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,003.41 / $9,370.62 / $11,238.98
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11,357.28 / $11,357.28 / $13,769.33
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$618.04 / $907.73 / $1,278.89