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Illinois rates for HCPCS L5704

Custom shaped protective cover, below knee (BK)

Facilitymedian $851 · 10th–90th $372–$3,8900%20%10th90th$851Professionalmedian $427 · 10th–90th $288–$7760%20%10th90th$427$1.0$5.0$20.0$100.0$500.0$2.0K$10.0K

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
$371.54 / $371.54 / $776.25
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$281.84 / $371.54 / $691.83
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$562.34 / $562.34 / $575.44
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$912.01 / $1,479.11 / $5,248.07
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$575.44 / $575.44 / $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
$288.40 / $288.40 / $812.83
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$630.96 / $776.25 / $977.24
Hally Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$977.24 / $977.24 / $977.24
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$426.58 / $426.58 / $602.56
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$416.87 / $616.60 / $1,023.29
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$281.84 / $380.19 / $630.96