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Arizona rates for HCPCS L5704

Custom shaped protective cover, below knee (BK)

Facilitymedian $603 · 10th–90th $204–$1,5490%10%10th90th$603Professionalmedian $372 · 10th–90th $275–$6760%20%10th90th$372$1.0$5.0$20.0$100.0$500.0$2.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$275.42 / $371.54 / $630.96
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$478.63 / $478.63 / $489.78
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$190.55 / $794.33 / $1,479.11
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$562.34 / $724.44 / $1,412.54
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$398.11 / $398.11 / $398.11
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$288.40 / $288.40 / $398.11
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$204.17 / $501.19 / $3,311.31
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$281.84 / $316.23 / $3,630.78
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$363.08 / $489.78 / $602.56
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$245.47 / $316.23 / $478.63