go back

Nebraska rates for HCPCS L5707

Custom shaped protective cover, hip disarticulation

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,100.70 / $1,100.70 / $1,100.70
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,100.70 / $1,100.70 / $1,297.83
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,516.99 / $1,668.69 / $1,685.55
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,232.20 / $1,898.60 / $1,898.60
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,232.20 / $1,898.60 / $2,927.69
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$908.78 / $1,871.19 / $7,733.84
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$657.14 / $987.64 / $1,435.14
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,893.05 / $1,898.60 / $2,392.19
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,654.00 / $2,243.80 / $3,911.44
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$657.14 / $861.08 / $1,141.43