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Maine rates for HCPCS L5704

Custom shaped protective cover, below knee (BK)

Facilitymedian $832 · 10th–90th $398–$9120%20%10th90th$832Professionalmedian $398 · 10th–90th $295–$7240%10%20%10th90th$398$200.0$500.0$1.0K$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$288.40 / $371.54 / $1,096.48
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$707.95 / $851.14 / $954.99
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$380.19 / $380.19 / $724.44
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$398.11 / $398.11 / $524.81
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$288.40 / $288.40 / $398.11
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$630.96 / $630.96 / $741.31
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$288.40 / $380.19 / $478.63
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$199.53 / $363.08 / $416.87
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$263.03 / $616.60 / $645.65