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Tennessee rates for HCPCS L6697

Addition To Upper Extremity Prosthesis Below Elbow/Above Elbow Custom

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$678.39 / $691.69 / $691.69
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$677.19 / $691.69 / $1,188.32
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$951.26 / $1,436.92 / $1,436.92
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,111.22 / $1,111.22 / $1,111.22
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$811.19 / $811.19 / $1,111.22
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,155.38 / $7,396.37 / $7,396.37
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8,010.83 / $8,010.83 / $11,624.25
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$531.01 / $796.51 / $1,083.25