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Minnesota rates for HCPCS L5705

Custom shaped protective cover, above knee (AK)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,148.15 / $1,148.15 / $1,148.15
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$501.19 / $691.83 / $1,148.15
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,348.96 / $1,380.38 / $2,041.74
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,096.48 / $1,380.38 / $1,380.38
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,951.21 / $5,128.61 / $12,302.69
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,621.81 / $1,819.70 / $2,041.74
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,981.07 / $5,128.61 / $9,772.37
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,621.81 / $1,621.81 / $2,187.76
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$549.54 / $1,380.38 / $2,511.89
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$371.54 / $575.44 / $1,380.38
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.91 / $741.31 / $1,513.56
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$371.54 / $630.96 / $1,621.81