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Below-Knee Prosthesis Protective Cover, Custom-Shaped

Illinois 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?

$589

Typical negotiated rate. In Illinois, July 2026.

Insurers have agreed to pay about $589 for this service. The price depends on where it is billed: about $575 from a physician practice, and about $776 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$575$372 to $589
FacilityA hospital or hospital-owned outpatient department$776$372 to $1,349

How much rates vary

Facilitymedian $776 · 10th to 90th $372 to $3,890Professionalmedian $575 · 10th to 90th $302 to $776
$200$500$1K$2K$5Kfacility $776professional $575

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
$371.54
Median
$371.54
Typical High
$776.25
Aetna
Setting
Professional
Modifier
Global
Typical Low
$295.12
Median
$371.54
Typical High
$776.25
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$537.03
Median
$562.34
Typical High
$575.44
BCBS
Setting
Facility
Modifier
Global
Typical Low
$912.01
Median
$1,479.11
Typical High
$5,248.07
BCBS
Setting
Professional
Modifier
Global
Typical Low
$588.84
Median
$588.84
Typical High
$588.84
Cigna
Setting
Facility
Modifier
Global
Typical Low
$398.11
Median
$398.11
Typical High
$831.76
Cigna
Setting
Professional
Modifier
Global
Typical Low
$288.40
Median
$288.40
Typical High
$758.58
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$630.96
Median
$776.25
Typical High
$977.24
Hally Health
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$977.24
Median
$977.24
Typical High
$977.24
Molina
Setting
Professional
Modifier
Global
Typical Low
$426.58
Median
$426.58
Typical High
$602.56
United
Setting
Facility
Modifier
Global
Typical Low
$416.87
Median
$616.60
Typical High
$776.25
United
Setting
Professional
Modifier
Global
Typical Low
$281.84
Median
$380.19
Typical High
$630.96

Where Illinois 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.

Illinois· 11th of 51

$589

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.