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Below-Knee Prosthesis Protective Cover, Custom-Shaped

Georgia 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?

$389

Typical negotiated rate. In Georgia, July 2026.

Insurers have agreed to pay about $389 for this service. The price depends on where it is billed: about $389 from a physician practice, and about $661 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 7 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$389$309 to $537
FacilityA hospital or hospital-owned outpatient department$661$282 to $977

How much rates vary

Facilitymedian $661 · 10th to 90th $269 to $2,399Professionalmedian $389 · 10th to 90th $269 to $646
$200$500$1K$2Kfacility $661professional $389

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
Facility
Modifier
Global
Typical Low
$269.15
Median
$269.15
Typical High
$794.33
Aetna
Setting
Professional
Modifier
Global
Typical Low
$269.15
Median
$346.74
Typical High
$537.03
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$478.63
Median
$478.63
Typical High
$478.63
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$660.69
Median
$1,548.82
Typical High
$2,398.83
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$346.74
Median
$537.03
Typical High
$851.14
CareSource
Setting
Facility
Modifier
Global
Typical Low
$549.54
Median
$549.54
Typical High
$549.54
CareSource
Setting
Professional
Modifier
Global
Typical Low
$549.54
Median
$549.54
Typical High
$549.54
Cigna
Setting
Facility
Modifier
Global
Typical Low
$398.11
Median
$398.11
Typical High
$977.24
Cigna
Setting
Professional
Modifier
Global
Typical Low
$288.40
Median
$288.40
Typical High
$870.96
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$467.74
Median
$660.69
Typical High
$891.25
United
Setting
Facility
Modifier
Global
Typical Low
$245.47
Median
$478.63
Typical High
$660.69
United
Setting
Professional
Modifier
Global
Typical Low
$213.80
Median
$323.59
Typical High
$630.96

Where Georgia 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.

Georgia· 29th of 51

$389

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.