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Massachusetts rates for HCPCS L5705

Custom shaped protective cover, above knee (AK)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$571.22 / $571.22 / $571.22
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$571.22 / $571.22 / $956.15
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,169.72 / $3,689.30 / $5,814.95
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$565.98 / $942.70 / $1,276.73
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,387.64 / $1,688.22 / $2,174.11
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$941.68 / $1,098.95 / $1,098.95
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$756.20 / $895.43 / $916.54
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$653.66 / $895.43 / $1,604.63
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$83.43 / $4,618.00 / $9,239.00
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,058.53 / $1,058.53 / $1,111.46
Health New England
Facility/Professional
Professional
Modifier
Low / Median / High Price
$986.30 / $986.30 / $986.30
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,809.97 / $5,814.95 / $5,814.95
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$510.69 / $698.83 / $1,276.73
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$556.23 / $698.83 / $1,251.57