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Delaware rates for HCPCS L5704

Custom shaped protective cover, below knee (BK)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$278.72 / $290.14 / $328.82
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 / $394.91
Highmark BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$705.03 / $705.03 / $705.03
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$317.58 / $376.86 / $529.84