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Tennessee rates for HCPCS L5642

Addition to lower extremity, above knee (AK), leather socket

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$315.97 / $322.17 / $322.17
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$315.97 / $335.79 / $553.48
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$443.06 / $669.27 / $669.27
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$397.50 / $530.41 / $530.41
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$387.20 / $387.20 / $530.41
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,331.18 / $3,873.08 / $3,966.04
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,937.72 / $4,937.72 / $6,655.88
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$247.32 / $370.99 / $558.96