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Oklahoma rates for HCPCS L5707

Custom Shaped Protective Cover Hip Disarticulation

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$637.37 / $637.37 / $637.37
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$637.37 / $728.42 / $735.27
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$885.07 / $1,300.75 / $1,300.75
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 / $1,232.20 / $1,232.20
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$478.20 / $892.18 / $7,733.84
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$493.82 / $978.83 / $1,503.79
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$493.82 / $710.16 / $1,115.80