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Indiana rates for HCPCS L5704

Custom shaped protective cover, below knee (BK)

Facilitymedian $776 · 10th–90th $363–$8130%50%10th90th$776Professionalmedian $372 · 10th–90th $295–$5750%50%10th90th$372$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
$363.08 / $363.08 / $363.08
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$288.40 / $363.08 / $562.34
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$380.19 / $776.25 / $954.99
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$380.19 / $380.19 / $691.83
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$645.65 / $831.76 / $954.99
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$398.11 / $398.11 / $776.25
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$288.40 / $288.40 / $660.69
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$416.87 / $478.63 / $616.60
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$208.93 / $380.19 / $537.03