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Below-Knee Prosthesis Protective Cover, Custom-Shaped

Connecticut 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?

$347

Typical negotiated rate. In Connecticut, July 2026.

Insurers have agreed to pay about $347 for this service. The price depends on where it is billed: about $347 from a physician practice, and about $490 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$347$295 to $407
FacilityA hospital or hospital-owned outpatient department$490$417 to $692

How much rates vary

Facilitymedian $490 · 10th to 90th $398 to $724Professionalmedian $347 · 10th to 90th $275 to $646
$500$1K$2Kfacility $490professional $347

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. Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

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

Where Connecticut 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.

Connecticut· 45th of 51

$347

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.