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Tennessee rates for HCPCS L5692

Addition to lower extremity, above knee (AK), pelvic control belt, light

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$67.61 / $67.61 / $120.23
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.61 / $81.28 / $134.90
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$120.23 / $120.23 / $128.82
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$72.44 / $72.44 / $100.00
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,000.00 / $1,000.00 / $1,000.00
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,202.26 / $1,202.26 / $1,202.26
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$61.66 / $104.71 / $123.03
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52.48 / $79.43 / $120.23