go back

Tennessee rates for HCPCS L5987

All lower extremity prostheses, shank foot system with vertical loading pylon

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,715.35 / $3,715.35 / $6,606.93
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,715.35 / $4,168.69 / $7,413.10
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6,606.93 / $6,918.31 / $7,943.28
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6,606.93 / $6,606.93 / $6,918.31
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,025.60 / $6,025.60 / $6,025.60
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,365.16 / $4,365.16 / $6,025.60
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40,738.03 / $40,738.03 / $40,738.03
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43,651.58 / $63,095.73 / $63,095.73
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,951.21 / $5,128.61 / $6,165.95
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,884.03 / $4,265.80 / $5,888.44