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Tennessee rates for HCPCS L5828

Addition, endoskeletal knee-shin system, single axis, fluid swing and stance phase control

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,445.44 / $1,445.44 / $2,570.40
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,445.44 / $1,778.28 / $2,951.21
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,691.53 / $3,019.95 / $3,388.44
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,570.40 / $2,570.40 / $2,691.53
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,137.96 / $2,137.96 / $2,137.96
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,548.82 / $1,548.82 / $2,137.96
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20,892.96 / $20,892.96 / $20,892.96
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20,892.96 / $30,902.95 / $30,902.95
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,288.25 / $2,238.72 / $2,630.27
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,122.02 / $1,698.24 / $2,570.40