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Tennessee rates for HCPCS L5707

Custom Shaped Protective Cover Hip Disarticulation

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$631.23 / $643.60 / $643.60
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$631.23 / $650.38 / $1,166.42
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$885.12 / $1,337.01 / $1,337.01
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$794.05 / $1,232.20 / $1,232.20
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$899.51 / $899.51 / $1,232.20
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,478.80 / $7,733.84 / $8,041.61
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8,380.20 / $8,380.20 / $12,300.60
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$494.09 / $741.14 / $1,141.43