go back

Wyoming rates for HCPCS L5705

Custom shaped protective cover, above knee (AK)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$603.39 / $603.39 / $1,056.71
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,178.50 / $1,178.50 / $1,178.50
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,178.50 / $1,178.50 / $1,178.50
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$895.43 / $895.43 / $1,347.58
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$653.66 / $653.66 / $895.43
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$502.73 / $556.23 / $857.13