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Missouri rates for HCPCS L5704

Custom shaped protective cover, below knee (BK)

Facilitymedian $603 · 10th–90th $347–$1,5490%20%10th90th$603Professionalmedian $380 · 10th–90th $282–$7080%20%10th90th$380$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
$338.84 / $501.19 / $501.19
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$275.42 / $371.54 / $707.95
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$758.58 / $758.58 / $2,691.53
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$380.19 / $389.05 / $707.95
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$457.09 / $457.09 / $758.58
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$398.11 / $398.11 / $416.87
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$288.40 / $288.40 / $398.11
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$354.81 / $588.84 / $1,659.59
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$245.47 / $371.54 / $3,630.78
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$416.87 / $602.56 / $602.56
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$263.03 / $371.54 / $549.54