go back

Below-Knee Prosthesis Protective Cover, Custom-Shaped

Connecticut rates for HCPCS L5704

Custom shaped protective cover, below knee (BK)

Rates data updated July 2026.

Facilitymedian $490 · 10th–90th $398$7240%10%20%10th90th$490Professionalmedian $347 · 10th–90th $275$6460%10%20%10th90th$347$200.0$500.0$1.0K$2.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample; interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$275.42
Median
$316.23
Typical High
$741.31
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$562.34
Median
$724.44
Typical High
$870.96
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$380.19
Median
$407.38
Typical High
$724.44
Cigna
Setting
Facility
Modifier
Global
Typical Low
$398.11
Median
$398.11
Typical High
$691.83
Cigna
Setting
Professional
Modifier
Global
Typical Low
$288.40
Median
$288.40
Typical High
$288.40
ConnectiCare
Setting
Facility
Modifier
Global
Typical Low
$467.74
Median
$467.74
Typical High
$467.74
ConnectiCare
Setting
Professional
Modifier
Global
Typical Low
$457.09
Median
$524.81
Typical High
$758.58
Health New England
Setting
Facility
Modifier
Global
Typical Low
$512.86
Median
$512.86
Typical High
$512.86
Health New England
Setting
Professional
Modifier
Global
Typical Low
$512.86
Median
$512.86
Typical High
$512.86
United
Setting
Facility
Modifier
Global
Typical Low
$263.03
Median
$478.63
Typical High
$489.78
United
Setting
Professional
Modifier
Global
Typical Low
$269.15
Median
$354.81
Typical High
$588.84