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Tennessee rates for HCPCS L5670

Addition to lower extremity, below knee (BK), molded supracondylar suspension (PTS or similar)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$138.38 / $141.10 / $141.10
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$138.38 / $146.63 / $242.40
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$244.27 / $244.27 / $325.69
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$194.05 / $293.12 / $293.12
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$174.09 / $203.51 / $203.51
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$148.56 / $148.56 / $203.51
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$550.59 / $1,717.84 / $2,062.69
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,162.57 / $2,162.57 / $2,527.19
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$108.32 / $162.47 / $244.81