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Kentucky rates for HCPCS L5704

Custom Shaped Protective Cover Below Knee

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$229.72 / $306.18 / $318.42
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$273.36 / $345.72 / $402.43
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$400.49 / $643.35 / $676.16
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$300.89 / $379.58 / $384.00
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$482.51 / $907.12 / $1,208.02
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$641.76 / $868.26 / $1,061.53
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$394.91 / $394.91 / $812.28
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$288.27 / $394.91 / $3,404.51
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$336.20 / $410.01 / $512.51
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$213.97 / $323.51 / $482.29