go back

Tennessee rates for HCPCS L5595

Preparatory, hip disarticulation/hemipelvectomy, pylon, no cover, SACH foot, thermoplastic or equal, molded to patient model

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,165.85 / $2,208.32 / $2,208.32
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,123.39 / $2,208.32 / $3,793.86
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,037.01 / $4,587.55 / $4,587.55
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,583.30 / $3,578.08 / $3,578.08
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,612.00 / $2,612.00 / $3,578.08
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,286.71 / $25,854.57 / $30,607.53
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45,109.85 / $46,192.50 / $46,192.50
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,695.32 / $2,542.96 / $3,632.67