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Tennessee rates for HCPCS L5699

All Lower Extremity Prostheses Shoulder Harness

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$120.60 / $122.97 / $122.97
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$99.35 / $122.97 / $211.26
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$169.11 / $255.45 / $255.45
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$119.62 / $169.96 / $169.96
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$124.07 / $124.07 / $169.96
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$443.49 / $1,197.00 / $1,417.31
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,711.98 / $1,753.07 / $1,753.07
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$93.04 / $141.61 / $172.04