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Missouri rates for HCPCS L5706

Custom Shaped Protective Cover Knee Disarticulation

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$554.74 / $820.55 / $846.83
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$554.74 / $668.24 / $1,155.71
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,214.22 / $1,274.93 / $5,604.84
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$656.97 / $656.97 / $982.35
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$957.73 / $957.73 / $957.73
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$699.14 / $699.14 / $1,020.99
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$554.74 / $978.56 / $5,705.72
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$454.76 / $656.24 / $1,166.76
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$595.23 / $595.23 / $595.23
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$454.76 / $610.36 / $859.85