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New York rates for HCPCS L5705

Custom shaped protective cover, above knee (AK)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$457.09 / $1,000.00 / $1,445.44
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$478.63 / $660.69 / $1,000.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,288.25 / $1,288.25 / $2,570.40
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$707.95 / $707.95 / $2,137.96
CDPHP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$977.24 / $1,047.13 / $1,047.13
CDPHP
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,047.13 / $1,047.13 / $1,047.13
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$891.25 / $1,995.26 / $50,118.72
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$660.69 / $660.69 / $1,258.93
Emblem Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,288.25 / $2,089.30 / $4,897.79
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$794.33 / $1,348.96 / $2,454.71
Excellus BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$891.25 / $891.25 / $933.25
Excellus BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$758.58 / $794.33 / $891.25
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,905.46 / $50,118.72 / $75,857.76
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$831.76 / $1,230.27 / $1,230.27
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$457.09 / $870.96 / $1,513.56
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$416.87 / $676.08 / $1,047.13
Univera
Facility/Professional
Facility
Modifier
Low / Median / High Price
$758.58 / $776.25 / $933.25
Univera
Facility/Professional
Professional
Modifier
Low / Median / High Price
$758.58 / $794.33 / $891.25