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Arizona rates for HCPCS L5706

Custom shaped protective cover, knee disarticulation

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$478.63 / $660.69 / $2,570.40
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$851.14 / $851.14 / $851.14
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$316.23 / $724.44 / $1,513.56
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$912.01 / $1,202.26 / $2,290.87
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$954.99 / $954.99 / $954.99
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$691.83 / $691.83 / $954.99
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$354.81 / $794.33 / $5,754.40
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$489.78 / $549.54 / $5,888.44
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$416.87 / $831.76 / $954.99
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$489.78 / $549.54 / $812.83