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Below-Knee Prosthesis Protective Cover, Custom-Shaped

Alaska rates for HCPCS L5704

Custom shaped protective cover, below knee (BK)

Rates data updated July 2026.

How much does Below-Knee Prosthesis Protective Cover, Custom-Shaped cost?

$501

Typical negotiated rate. In Alaska, July 2026.

Insurers have agreed to pay about $501 for this service. The price depends on where it is billed: about $501 from a physician practice, and about $398 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 6 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$501$380 to $759
FacilityA hospital or hospital-owned outpatient department$398$204 to $741

How much rates vary

Facilitymedian $398 · 10th to 90th $204 to $759Professionalmedian $501 · 10th to 90th $355 to $1,072
$200$500$1K$2Kfacility $398professional $501

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$354.81
Median
$380.19
Typical High
$676.08
Cigna
Setting
Facility
Modifier
Global
Typical Low
$398.11
Median
$398.11
Typical High
$398.11
Cigna
Setting
Professional
Modifier
Global
Typical Low
$288.40
Median
$288.40
Typical High
$851.14
Moda Health
Setting
Facility
Modifier
Global
Typical Low
$204.17
Median
$489.78
Typical High
$758.58
Moda Health
Setting
Professional
Modifier
Global
Typical Low
$707.95
Median
$794.33
Typical High
$2,238.72
Premera BCBS
Setting
Facility
Modifier
Global
Typical Low
$645.65
Median
$758.58
Typical High
$794.33
Premera BCBS
Setting
Professional
Modifier
Global
Typical Low
$630.96
Median
$758.58
Typical High
$794.33
Providence
Setting
Facility
Modifier
Global
Typical Low
$204.17
Median
$204.17
Typical High
$741.31
Providence
Setting
Professional
Modifier
Global
Typical Low
$60.26
Median
$398.11
Typical High
$691.83
United
Setting
Facility
Modifier
Global
Typical Low
$416.87
Median
$478.63
Typical High
$501.19
United
Setting
Professional
Modifier
Global
Typical Low
$323.59
Median
$389.05
Typical High
$1,513.56

Where Alaska sits

The same service costs 2.8 times more in Hawaii than in Nebraska. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Alaska· 15th of 51

$501

HI $794NE $282

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.