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Maine rates for HCPCS L5705

Custom Shaped Protective Cover Above Knee

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$571.22 / $880.52 / $880.52
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,162.77 / $1,506.48 / $2,792.54
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$686.95 / $711.48 / $981.51
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$895.43 / $895.43 / $960.89
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$653.66 / $653.66 / $895.43
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,058.53 / $1,058.53 / $1,058.53
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$736.13 / $880.52 / $880.52
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$434.82 / $733.77 / $1,499.94