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Iowa rates for HCPCS L5704

Custom shaped protective cover, below knee (BK)

Facilitymedian $724 · 10th–90th $437–$1,8620%10%20%10th90th$724Professionalmedian $398 · 10th–90th $275–$7590%10%20%10th90th$398$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
Facility
Modifier
Typical Low / Median / Typical High
$512.86 / $575.44 / $630.96
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$275.42 / $371.54 / $575.44
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$398.11 / $398.11 / $831.76
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$398.11 / $870.96 / $1,096.48
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$645.65 / $758.58 / $831.76
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$512.86 / $954.99 / $3,311.31
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$346.74 / $478.63 / $1,258.93
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$812.83 / $851.14 / $977.24
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$831.76 / $831.76 / $831.76
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$724.44 / $1,258.93 / $1,258.93
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$309.03 / $758.58 / $1,659.59
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$346.74 / $398.11 / $707.95
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$575.44 / $724.44 / $724.44