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Mississippi rates for HCPCS L5704

Custom Shaped Protective Cover Below Knee

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$360.54 / $360.54 / $563.34
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$357.56 / $524.19 / $632.39
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$482.51 / $482.51 / $514.67
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$612.35 / $612.35 / $612.35
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$612.35 / $612.35 / $612.35
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 / $288.27 / $394.91
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$210.20 / $320.95 / $485.86