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Tennessee rates for HCPCS L5781

Addition To Lower Limb Prosthesis Vacuum Pump Residual Limb Volume Management And Moisture Evacuation System

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,063.53 / $2,103.98 / $2,103.98
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,051.64 / $2,103.98 / $3,614.61
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,856.45 / $4,856.45 / $4,856.45
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,893.52 / $4,370.81 / $4,370.81
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,520.06 / $2,886.72 / $2,886.72
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,107.31 / $2,107.31 / $2,886.72
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,556.21 / $22,493.11 / $22,493.11
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$24,318.59 / $24,318.59 / $35,358.60
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,615.22 / $2,422.83 / $3,294.23