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Kansas rates for HCPCS L5704

Custom Shaped Protective Cover Below Knee

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$561.11 / $561.11 / $561.11
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$203.55 / $390.64 / $625.03
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$593.71 / $624.96 / $664.79
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$656.21 / $656.21 / $656.21
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 / $394.90 / $1,094.06
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$203.55 / $601.39 / $3,305.62
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$210.20 / $422.28 / $953.33
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$248.18 / $372.28 / $500.05