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Arizona rates for HCPCS L5707

Custom shaped protective cover, hip disarticulation

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$664.58 / $761.84 / $1,105.70
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$406.31 / $1,467.80 / $2,653.73
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,015.78 / $1,354.38 / $1,845.34
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,232.20 / $1,232.20 / $1,232.20
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$899.51 / $899.51 / $2,103.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$478.20 / $1,131.18 / $7,733.84
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$669.48 / $740.73 / $1,141.43
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$669.48 / $740.73 / $1,115.80