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Texas rates for HCPCS L5704

Custom shaped protective cover, below knee (BK)

Facilitymedian $513 · 10th–90th $282–$1,4450%10%20%10th90th$513Professionalmedian $316 · 10th–90th $275–$5620%20%40%10th90th$316$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
$281.84 / $281.84 / $302.00
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$275.42 / $338.84 / $562.34
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$354.81 / $380.19 / $489.78
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$309.03 / $309.03 / $501.19
Baylor Scott & White
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$457.09 / $489.78 / $660.69
Christus
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$79.43 / $660.69 / $660.69
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$398.11 / $398.11 / $426.58
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
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$281.84 / $537.03 / $891.25
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$275.42 / $354.81 / $676.08
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$371.54 / $371.54 / $380.19
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$281.84 / $501.19 / $891.25
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$288.40 / $288.40 / $398.11
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$281.84 / $489.78 / $724.44
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$263.03 / $389.05 / $478.63
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$380.19 / $660.69 / $660.69