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Arkansas rates for HCPCS L5707

Custom shaped protective cover, hip disarticulation

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$825.67 / $825.67 / $825.67
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$636.22 / $825.67 / $825.67
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$219,999.78 / $539,999.46 / $949,999.05
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,282.40 / $1,697.29 / $1,885.88
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,485.57 / $1,485.57 / $1,693.83
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,693.83 / $1,693.83 / $1,693.83
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,188.40 / $1,232.20 / $1,232.20
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$893.08 / $1,160.54 / $1,232.20
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$493.82 / $741.10 / $1,136.58