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Below-Knee Prosthesis Protective Cover, Custom-Shaped

North Carolina 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?

$479

Typical negotiated rate. In North Carolina, July 2026.

Insurers have agreed to pay about $479 for this service. The price depends on where it is billed: about $479 from a physician practice, and about $513 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$479$398 to $490
FacilityA hospital or hospital-owned outpatient department$513$437 to $692

How much rates vary

Facilitymedian $513 · 10th to 90th $295 to $1,259Professionalmedian $479 · 10th to 90th $288 to $490
$200$500$1K$2Kfacility $513professional $479

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
$478.63
Median
$478.63
Typical High
$478.63
Aetna
Setting
Professional
Modifier
Global
Typical Low
$275.42
Median
$478.63
Typical High
$478.63
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$489.78
Median
$489.78
Typical High
$489.78
BCBS
Setting
Facility
Modifier
Global
Typical Low
$602.56
Median
$954.99
Typical High
$1,288.25
BCBS
Setting
Professional
Modifier
Global
Typical Low
$489.78
Median
$489.78
Typical High
$489.78
Cigna
Setting
Facility
Modifier
Global
Typical Low
$288.40
Median
$398.11
Typical High
$416.87
Cigna
Setting
Professional
Modifier
Global
Typical Low
$288.40
Median
$288.40
Typical High
$416.87
Medcost
Setting
Professional
Modifier
Global
Typical Low
$302.00
Median
$323.59
Typical High
$467.74
Medcost
Setting
Facility
Modifier
Global
Typical Low
$269.15
Median
$537.03
Typical High
$933.25
United
Setting
Facility
Modifier
Global
Typical Low
$416.87
Median
$501.19
Typical High
$660.69
United
Setting
Professional
Modifier
Global
Typical Low
$263.03
Median
$323.59
Typical High
$489.78
Wellcare
Setting
Facility
Modifier
Global
Typical Low
$3,388.44
Median
$3,388.44
Typical High
$3,388.44
Wellcare
Setting
Professional
Modifier
Global
Typical Low
$3,715.35
Median
$3,715.35
Typical High
$5,128.61

Where North Carolina 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.

North Carolina· 16th of 51

$479

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.