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Utah rates for HCPCS L5705

Custom shaped protective cover, above knee (AK)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$359.09 / $359.09 / $359.09
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$359.09 / $389.30 / $3,466.84
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$895.43 / $895.43 / $895.43
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$653.66 / $895.43 / $954.57
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$546.20 / $880.98 / $1,145.27
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,056.71 / $1,178.50 / $1,178.50
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$671.08 / $844.75 / $1,267.11
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$502.22 / $556.23 / $797.98