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Tennessee rates for HCPCS L5643

Addition to lower extremity, hip disarticulation, flexible inner socket, external frame

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$793.76 / $809.33 / $809.33
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$793.76 / $812.96 / $1,390.41
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,113.03 / $1,681.29 / $1,681.29
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$998.58 / $1,167.30 / $1,167.30
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$852.13 / $852.13 / $1,167.30
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,168.05 / $9,793.70 / $9,963.20
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12,404.18 / $12,404.18 / $14,010.75
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$621.32 / $931.98 / $1,404.20