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Below-Knee Prosthesis Protective Cover, Custom-Shaped

Delaware rates for HCPCS L5704

Custom shaped protective cover, below knee (BK)

Rates data updated July 2026.

Facilitymedian $398 · 10th–90th $1$4790%50%10th90th$398Professionalmedian $316 · 10th–90th $282$2,8180%20%40%10th90th$316$1.0$5.0$20.0$100.0$500.0$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
$281.84
Median
$316.23
Typical High
$2,818.38
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
$426.58
United
Setting
Facility
Modifier
Global
Typical Low
$0.50
Median
$363.08
Typical High
$478.63
United
Setting
Professional
Modifier
Global
Typical Low
$316.23
Median
$380.19
Typical High
$524.81