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Tennessee rates for HCPCS L4360

Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$147.91 / $162.18 / $263.03
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$141.25 / $177.83 / $354.81
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$177.83 / $245.47 / $323.59
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$251.19 / $251.19 / $263.03
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$186.21 / $194.98 / $194.98
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$141.25 / $141.25 / $194.98
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,737.80 / $1,737.80 / $1,737.80
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,412.54 / $2,454.71 / $2,454.71
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$97.72 / $154.88 / $199.53
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$109.65 / $158.49 / $223.87