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Tennessee rates for HCPCS L5668

Addition to lower extremity, below knee (BK), molded distal cushion

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$57.58 / $58.71 / $58.71
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.57 / $58.71 / $100.87
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$101.64 / $101.64 / $101.64
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$80.73 / $121.97 / $121.97
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$64.78 / $89.19 / $89.19
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$65.11 / $65.11 / $89.19
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$211.74 / $645.28 / $767.65
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$799.97 / $799.97 / $947.55
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.07 / $67.61 / $91.11