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Tennessee rates for HCPCS L6638

Upper extremity addition to prosthesis, electric locking feature, only for use with manually powered elbow

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,289.70 / $1,314.99 / $1,314.99
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,282.28 / $1,314.99 / $2,259.12
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,808.45 / $2,731.74 / $2,731.74
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,575.05 / $1,952.91 / $1,952.91
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,425.62 / $1,425.62 / $1,952.91
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,097.60 / $14,058.21 / $14,058.21
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15,199.11 / $15,199.11 / $22,099.20
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,009.51 / $1,514.26 / $2,027.18