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Virginia rates for HCPCS L5704

Custom shaped protective cover, below knee (BK)

Facilitymedian $724 · 10th–90th $372–$8910%20%40%10th90th$724Professionalmedian $380 · 10th–90th $295–$6460%50%10th90th$380$1.0$5.0$20.0$100.0$500.0$2.0K$10.0K

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 / $371.54
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$288.40 / $371.54 / $537.03
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$724.44 / $724.44 / $758.58
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$380.19 / $380.19 / $794.33
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$380.19 / $380.19 / $489.78
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$316.23 / $398.11 / $398.11
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$288.40 / $288.40 / $398.11
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$537.03 / $724.44 / $1,000.00
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$323.59 / $467.74 / $707.95
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$281.84 / $478.63 / $831.76
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$389.05 / $407.38 / $467.74
Sentara
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$407.38 / $588.84 / $1,548.82
Sentara
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$407.38 / $588.84 / $1,548.82
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$245.47 / $478.63 / $851.14
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$316.23 / $354.81 / $562.34