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Tennessee rates for HCPCS L5974

All lower extremity prostheses, foot, single axis ankle/foot

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$118.85 / $121.18 / $121.18
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$118.85 / $121.72 / $208.17
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$166.64 / $251.72 / $251.72
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$149.50 / $174.77 / $174.77
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$127.58 / $127.58 / $174.77
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$489.75 / $1,528.02 / $1,771.42
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,135.48 / $2,186.73 / $2,186.73
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$93.02 / $139.54 / $210.24