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Alabama rates for HCPCS L5704

Custom Shaped Protective Cover Below Knee

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$540.80 / $540.80 / $540.80
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$274.67 / $540.80 / $540.80
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$397.35 / $397.35 / $397.35
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$394.91 / $394.91 / $755.01
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$288.27 / $394.91 / $661.11
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$210.20 / $320.95 / $485.86