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Tennessee rates for HCPCS L6925

Wrist disarticulation, external power, self-suspended inner socket, removable forearm shell, Otto Bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,581.72 / $4,671.56 / $4,671.56
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,066.13 / $4,671.56 / $8,025.65
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6,424.59 / $9,704.67 / $9,704.67
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,943.14 / $7,261.93 / $7,261.93
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,301.21 / $5,301.21 / $7,261.93
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16,848.38 / $48,028.87 / $48,511.09
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52,297.82 / $52,297.82 / $69,356.55
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,586.34 / $5,379.50 / $7,108.70