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Above Knee (AK), Proximal Femoral Focal Deficiency

Tennessee rates for HCPCS L5230

Above knee (AK), for proximal femoral focal deficiency, constant friction knee, shin, SACH foot

Rates data updated October 2026.

How much does Above Knee (AK), Proximal Femoral Focal Deficiency cost?

$2,692

Typical negotiated rate. In Tennessee, October 2026.

Insurers have agreed to pay about $2,692 for this service. The price depends on where it is billed: about $2,399 from a physician practice, and about $2,884 from a hospital or other facility.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 5 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$2,399$2,089 to $3,467
FacilityA hospital or hospital-owned outpatient department$2,884$2,884 to $3,020

How much rates vary

Facilitymedian $2,884 · 10th to 90th $2,884 to $3,090Professionalmedian $2,399 · 10th to 90th $1,950 to $30,903
$2K$5K$10K$20Kfacility $2,884professional $2,399

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$1,995.26
Median
$1,995.26
Typical High
$1,995.26
Aetna
Setting
Professional
Modifier
None
Typical Low
$1,949.84
Median
$1,995.26
Typical High
$2,754.23
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$977.24
Median
$1,000.00
Typical High
$1,380.38
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$389.05
Median
$398.11
Typical High
$549.54
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$288.40
Median
$295.12
Typical High
$407.38
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$194.98
Median
$199.53
Typical High
$275.42
BCBS Tennessee
Setting
Professional
Modifier
None
Typical Low
$2,691.53
Median
$3,467.37
Typical High
$3,467.37
Cigna
Setting
Facility
Modifier
None
Typical Low
$2,884.03
Median
$2,884.03
Typical High
$3,019.95
Cigna
Setting
Professional
Modifier
None
Typical Low
$2,089.30
Median
$2,089.30
Typical High
$2,884.03
Lucent Health
Setting
Professional
Modifier
None
Typical Low
$30,902.95
Median
$34,673.69
Typical High
$34,673.69
United
Setting
Facility
Modifier
None
Typical Low
$3,019.95
Median
$3,019.95
Typical High
$3,090.30
United
Setting
Professional
Modifier
None
Typical Low
$1,513.56
Median
$2,238.72
Typical High
$3,467.37

Where Tennessee sits

The same service costs 3.4 times more in Hawaii than in Delaware. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Tennessee· 41st of 51

$2,692

HI $7,079DE $2,089

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.