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Tennessee rates for HCPCS L5640

Addition to lower extremity, knee disarticulation, leather socket

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$323.59 / $323.59 / $575.44
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$323.59 / $416.87 / $645.65
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$575.44 / $575.44 / $616.60
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$575.44 / $575.44 / $575.44
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$416.87 / $416.87 / $575.44
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,466.84 / $4,466.84 / $4,466.84
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,128.61 / $7,762.47 / $7,762.47
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$295.12 / $501.19 / $588.84
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$257.04 / $380.19 / $575.44