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Indiana rates for HCPCS L5706

Custom Shaped Protective Cover Knee Disarticulation

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$642.54 / $642.54 / $1,350.12
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$557.73 / $642.54 / $668.24
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,066.58 / $1,208.35 / $1,350.12
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$656.97 / $656.97 / $906.61
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$957.82 / $1,417.63 / $1,890.17
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,147.59 / $1,485.13 / $1,822.66
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$957.73 / $957.73 / $1,350.12
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$699.14 / $957.73 / $1,335.64
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$595.23 / $595.23 / $595.23
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$363.80 / $673.56 / $892.87