go back

Indiana rates for HCPCS L5707

Custom shaped protective cover, hip disarticulation

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$863.27 / $863.27 / $1,813.93
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$735.27 / $863.27 / $897.80
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,433.00 / $1,623.47 / $1,813.93
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$891.75 / $902.90 / $1,235.23
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,262.73 / $1,904.63 / $2,539.50
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,541.84 / $1,995.32 / $2,448.81
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,232.20 / $1,232.20 / $1,813.93
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$899.51 / $1,232.20 / $1,801.91
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$493.82 / $904.95 / $1,199.58