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Tennessee rates for HCPCS L5705

Custom shaped protective cover, above knee (AK)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$488.45 / $498.03 / $498.03
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$488.45 / $503.24 / $855.61
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$862.17 / $862.17 / $862.17
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$684.91 / $1,034.59 / $1,034.59
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$614.41 / $895.43 / $895.43
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$653.66 / $653.66 / $895.43
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,551.91 / $5,814.95 / $5,814.95
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6,083.01 / $6,228.99 / $9,386.78
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$382.34 / $573.50 / $838.07