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South Carolina rates for HCPCS L5705

Custom Shaped Protective Cover Above Knee

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$514.26 / $514.26 / $514.26
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$514.26 / $514.26 / $855.61
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$665.00 / $838.40 / $1,218.53
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$511.97 / $895.43 / $988.61
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$653.66 / $691.27 / $895.43
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$511.55 / $824.00 / $1,805.38
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$646.00 / $646.00 / $695.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$776.79 / $776.79 / $776.79
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$435.52 / $568.39 / $838.07