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Tennessee rates for HCPCS L5613

Addition To Lower Extremity Endoskeletal System Above Knee- Knee Disarticulation 4 Bar Linkage With Hydraulic Swing Phase Control

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,284.67 / $1,309.85 / $1,309.85
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,280.05 / $1,309.85 / $2,420.06
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,801.39 / $2,721.10 / $2,721.10
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,572.30 / $1,902.78 / $1,902.78
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,389.03 / $1,389.03 / $1,902.78
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,950.00 / $15,444.00 / $18,629.07
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18,825.16 / $18,825.16 / $22,060.73
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,005.57 / $1,508.36 / $2,210.98