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Tennessee rates for HCPCS L5988

Addition to lower limb prosthesis, vertical shock reducing pylon feature

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,030.27 / $1,050.47 / $1,050.47
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,028.46 / $1,050.47 / $1,804.69
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,444.67 / $2,182.23 / $2,182.23
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,258.22 / $1,346.19 / $1,346.19
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$982.72 / $982.72 / $1,346.19
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,273.35 / $11,271.87 / $11,271.87
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12,141.34 / $12,141.34 / $17,653.95
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$806.44 / $1,209.66 / $1,656.24