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Missouri rates for HCPCS L5705

Custom shaped protective cover, above knee (AK)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$562.34 / $831.76 / $831.76
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$501.19 / $676.08 / $1,778.28
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,258.93 / $1,258.93 / $4,365.16
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$676.08 / $691.83 / $1,148.15
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$741.31 / $741.31 / $1,258.93
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$562.34 / $891.25 / $891.25
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$660.69 / $660.69 / $891.25
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$616.60 / $977.24 / $2,818.38
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$436.52 / $630.96 / $6,025.60
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$741.31 / $977.24 / $1,202.26
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$436.52 / $616.60 / $870.96