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California rates for HCPCS L5705

Custom Shaped Protective Cover Above Knee

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$669.63 / $669.63 / $3,466.84
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$503.24 / $669.63 / $3,466.84
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$508.50 / $1,842.04 / $3,814.21
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$675.26 / $686.95 / $1,287.32
Blue Shield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$97.00 / $1,422.56 / $2,540.28
Blue Shield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$100.00 / $1,594.30 / $3,713.64
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$562.00 / $895.43 / $895.43
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$653.66 / $653.66 / $954.57
Contra Costa Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$445.55 / $534.66 / $1,321.75
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$720.95 / $841.11 / $1,826.42
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,325.48 / $5,814.95 / $5,814.95
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6,083.01 / $6,228.99 / $9,386.78
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,356.29 / $2,356.29 / $2,356.29
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$359.09 / $1,043.72 / $1,217.82
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$653.66 / $895.43 / $1,143.69
Sutter Health Plus
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,267.92 / $2,267.92 / $2,267.92
The Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$445.55 / $757.44 / $961.27
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$523.58 / $594.11 / $1,201.58