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Ohio rates for HCPCS L5704

Custom shaped protective cover, below knee (BK)

Facilitymedian $813 · 10th–90th $398$1,3490%20%10th90th$813Professionalmedian $372 · 10th–90th $288$6310%20%10th90th$372$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
$371.54 / $371.54 / $630.96
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$275.42 / $371.54 / $537.03
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$380.19 / $380.19 / $380.19
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$776.25 / $812.83 / $1,659.59
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$371.54 / $446.68 / $977.24
Aultcare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$645.65 / $645.65 / $645.65
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$323.59 / $549.54 / $776.25
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$416.87 / $575.44 / $870.96
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
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$398.11 / $398.11 / $398.11
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$288.40 / $288.40 / $398.11
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$331.13 / $457.09 / $660.69
SummaCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$933.25 / $933.25 / $933.25
SummaCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$724.44 / $870.96 / $1,584.89
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$281.84 / $524.81 / $776.25
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$251.19 / $371.54 / $489.78