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Tennessee rates for HCPCS L5968

Addition to lower limb prosthesis, multiaxial ankle with swing phase active dorsiflexion feature

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,874.12 / $1,910.87 / $1,910.87
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,870.82 / $1,910.87 / $3,282.84
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,308.03 / $3,308.03 / $4,410.70
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,627.94 / $3,969.63 / $3,969.63
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,288.76 / $2,448.80 / $2,448.80
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,787.62 / $1,787.62 / $2,448.80
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,954.45 / $20,504.11 / $20,504.11
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22,086.40 / $22,086.40 / $32,113.28
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,466.97 / $2,200.44 / $2,945.77