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Arizona rates for HCPCS L5705

Custom shaped protective cover, above knee (AK)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$514.26 / $540.72 / $855.61
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$315.45 / $1,139.60 / $2,060.37
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$788.65 / $1,051.54 / $1,432.72
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$895.43 / $895.43 / $895.43
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$653.66 / $653.66 / $1,604.63
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$359.09 / $802.86 / $5,814.95
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$502.73 / $556.23 / $857.13
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$502.73 / $556.23 / $837.88