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Below-Knee Prosthesis Protective Cover, Custom-Shaped

Kansas rates for HCPCS L5704

Custom shaped protective cover, below knee (BK)

Rates data updated October 2026.

How much does Below-Knee Prosthesis Protective Cover, Custom-Shaped cost?

$603

Typical negotiated rate. In Kansas, October 2026.

Insurers have agreed to pay about $603 for this service. The price depends on where it is billed: about $562 from a physician practice, and about $631 from a hospital or other facility.

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 5 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$562$372 to $724
FacilityA hospital or hospital-owned outpatient department$631$603 to $631

How much rates vary

Facilitymedian $631 · 10th to 90th $562 to $661Professionalmedian $562 · 10th to 90th $288 to $724
$200$500$1K$2Kfacility $631professional $562

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$562.34
Median
$562.34
Typical High
$562.34
Aetna
Setting
Professional
Modifier
None
Typical Low
$389.05
Median
$549.54
Typical High
$562.34
BCBS Kansas
Setting
Facility
Modifier
None
Typical Low
$602.56
Median
$630.96
Typical High
$630.96
BCBS Kansas
Setting
Professional
Modifier
None
Typical Low
$724.44
Median
$724.44
Typical High
$724.44
Cigna
Setting
Facility
Modifier
None
Typical Low
$398.11
Median
$398.11
Typical High
$398.11
Cigna
Setting
Professional
Modifier
None
Typical Low
$288.40
Median
$288.40
Typical High
$398.11
Medica
Setting
Facility
Modifier
None
Typical Low
$389.05
Median
$630.96
Typical High
$3,311.31
Medica
Setting
Professional
Modifier
None
Typical Low
$316.23
Median
$478.63
Typical High
$3,630.78
United
Setting
Facility
Modifier
None
Typical Low
$363.08
Median
$363.08
Typical High
$851.14
United
Setting
Professional
Modifier
None
Typical Low
$245.47
Median
$371.54
Typical High
$489.78
4 more rates with less common billing modifiers

A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.

Insurance Carrier
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$194.98
Median
$275.42
Typical High
$281.84
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$77.62
Median
$109.65
Typical High
$112.20
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$57.54
Median
$83.18
Typical High
$83.18
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$38.90
Median
$54.95
Typical High
$56.23

Where Kansas sits

The same service costs 2.8 times more in Hawaii than in Delaware. 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.

Kansas· 12th of 51

$603

HI $794DE $288

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.