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Michigan rates for HCPCS L5704

Custom shaped protective cover, below knee (BK)

Facilitymedian $851 · 10th–90th $417–$3,0200%20%10th90th$851Professionalmedian $389 · 10th–90th $282–$7590%20%10th90th$389$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
$426.58 / $426.58 / $426.58
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$275.42 / $371.54 / $478.63
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,000.00 / $2,290.87 / $4,365.16
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$758.58 / $758.58 / $794.33
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$416.87 / $416.87 / $416.87
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$398.11 / $398.11 / $398.11
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$288.40 / $398.11 / $776.25
Health Alliance Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$426.58 / $1,445.44 / $1,621.81
Health Alliance Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$371.54 / $602.56 / $933.25
Priority Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$398.11 / $398.11 / $398.11
Priority Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$288.40 / $501.19 / $707.95
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$416.87 / $616.60 / $851.14
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$263.03 / $354.81 / $501.19