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Tennessee rates for HCPCS L5200

Above knee (AK), molded socket, single axis constant friction knee, shin, SACH foot

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,865.43 / $1,902.01 / $1,902.01
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,865.43 / $1,902.01 / $3,267.61
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,615.75 / $3,951.23 / $3,951.23
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,119.42 / $2,728.17 / $2,728.17
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,991.56 / $1,991.56 / $2,728.17
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,859.76 / $20,802.65 / $22,879.56
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$24,201.14 / $24,201.14 / $29,750.55
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,460.16 / $2,190.25 / $2,980.36