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Tennessee rates for HCPCS L5704

Custom shaped protective cover, below knee (BK)

Facilitymedian $490 · 10th–90th $275–$3,3880%20%10th90th$490Professionalmedian $324 · 10th–90th $275–$5370%20%40%10th90th$324$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
$275.42 / $275.42 / $489.78
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$275.42 / $309.03 / $537.03
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$489.78 / $489.78 / $562.34
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$489.78 / $489.78 / $524.81
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$398.11 / $398.11 / $457.09
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$288.40 / $288.40 / $398.11
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,388.44 / $3,388.44 / $3,388.44
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,715.35 / $5,128.61 / $5,128.61
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$363.08 / $478.63 / $501.19
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $316.23 / $478.63