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Below-Knee Prosthesis Protective Cover, Custom-Shaped

Minnesota 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?

$759

Typical negotiated rate. In Minnesota, July 2026.

Insurers have agreed to pay about $759 for this service. The price depends on where it is billed: about $759 from a physician practice, and about $1,288 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 6 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$759$631 to $759
FacilityA hospital or hospital-owned outpatient department$1,288$759 to $2,884

How much rates vary

Facilitymedian $1,288 · 10th to 90th $646 to $6,166Professionalmedian $759 · 10th to 90th $501 to $871
$200$500$1K$2K$5Kfacility $1,288professional $759

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
$630.96
Median
$630.96
Typical High
$630.96
Aetna
Setting
Professional
Modifier
Global
Typical Low
$269.15
Median
$512.86
Typical High
$630.96
BCBS
Setting
Facility
Modifier
Global
Typical Low
$741.31
Median
$758.58
Typical High
$1,096.48
BCBS
Setting
Professional
Modifier
Global
Typical Low
$602.56
Median
$758.58
Typical High
$758.58
Cigna
Setting
Facility
Modifier
Global
Typical Low
$1,659.59
Median
$2,884.03
Typical High
$7,762.47
Cigna
Setting
Professional
Modifier
Global
Typical Low
$870.96
Median
$1,000.00
Typical High
$1,122.02
Health Partners
Setting
Facility
Modifier
Global
Typical Low
$2,187.76
Median
$3,162.28
Typical High
$6,165.95
Health Partners
Setting
Professional
Modifier
Global
Typical Low
$870.96
Median
$870.96
Typical High
$1,202.26
Medica
Setting
Facility
Modifier
Global
Typical Low
$295.12
Median
$758.58
Typical High
$3,311.31
Medica
Setting
Professional
Modifier
Global
Typical Low
$208.93
Median
$316.23
Typical High
$812.83
United
Setting
Facility
Modifier
Global
Typical Low
$5.01
Median
$416.87
Typical High
$1,023.29
United
Setting
Professional
Modifier
Global
Typical Low
$245.47
Median
$416.87
Typical High
$1,047.13

Where Minnesota 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.

Minnesota· 3rd of 51

$759

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.