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Florida rates for HCPCS L5704

Custom Shaped Protective Cover Below Knee

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$274.67 / $295.39 / $338.43
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$274.67 / $338.43 / $478.84
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$241.26 / $482.51 / $579.02
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 / $420.99
Florida Blue
Facility/Professional
Facility
Modifier
Low / Median / High Price
$428.26 / $428.26 / $428.26
Florida Blue
Facility/Professional
Professional
Modifier
Low / Median / High Price
$306.62 / $428.26 / $643.35
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$222.04 / $341.60 / $375.76
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$276.27 / $320.95 / $475.05
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$341.60 / $341.60 / $382.42