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Below-Knee Prosthesis Protective Cover, Custom-Shaped

Kentucky rates for HCPCS L5704

Custom shaped protective cover, below knee (BK)

Rates data updated July 2026.

Facilitymedian $417 · 10th–90th $309$9770%20%10th90th$417Professionalmedian $372 · 10th–90th $288$5010%50%10th90th$372$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$309.03
Median
$309.03
Typical High
$316.23
Aetna
Setting
Professional
Modifier
Global
Typical Low
$281.84
Median
$363.08
Typical High
$501.19
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$588.84
Median
$660.69
Typical High
$691.83
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$302.00
Median
$380.19
Typical High
$398.11
CareSource
Setting
Facility
Modifier
Global
Typical Low
$478.63
Median
$870.96
Typical High
$1,122.02
CareSource
Setting
Professional
Modifier
Global
Typical Low
$645.65
Median
$812.83
Typical High
$1,023.29
Cigna
Setting
Facility
Modifier
Global
Typical Low
$398.11
Median
$977.24
Typical High
$977.24
Cigna
Setting
Professional
Modifier
Global
Typical Low
$288.40
Median
$512.86
Typical High
$3,467.37
Molina
Setting
Professional
Modifier
Global
Typical Low
$338.84
Median
$426.58
Typical High
$549.54
United
Setting
Facility
Modifier
Global
Typical Low
$239.88
Median
$426.58
Typical High
$489.78
United
Setting
Professional
Modifier
Global
Typical Low
$213.80
Median
$346.74
Typical High
$489.78