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Tennessee rates for HCPCS L5620

Addition to lower extremity, test socket, below knee (BK)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$141.79 / $144.57 / $144.57
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$141.79 / $158.47 / $248.36
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$250.26 / $250.26 / $333.68
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$198.82 / $300.31 / $300.31
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$178.37 / $209.59 / $209.59
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$153.00 / $153.00 / $209.59
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$450.47 / $1,729.07 / $1,729.07
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,202.30 / $2,202.30 / $2,960.93
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$128.27 / $219.98 / $256.52
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$110.98 / $166.47 / $250.82