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Colorado rates for HCPCS L5704

Custom shaped protective cover, below knee (BK)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$355.37 / $355.37 / $355.37
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$237.13 / $355.37 / $484.43
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$710.73 / $798.58 / $1,449.89
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$384.00 / $384.00 / $414.72
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$394.91 / $394.91 / $394.91
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$288.27 / $288.27 / $798.48
Denver HMP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$203.55 / $355.37 / $888.41
Denver HMP
Facility/Professional
Professional
Modifier
Low / Median / High Price
$203.55 / $203.55 / $203.55
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$518.83 / $888.41 / $1,407.25
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$291.52 / $315.29 / $485.86