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Below-Knee Prosthesis Protective Cover, Custom-Shaped

North Dakota 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?

$646

Typical negotiated rate. In North Dakota, July 2026.

Insurers have agreed to pay about $646 for this service. The price depends on where it is billed: about $661 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 5 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$661$513 to $794
FacilityA hospital or hospital-owned outpatient department$513$513 to $631

How much rates vary

Facilitymedian $513 · 10th to 90th $513 to $871Professionalmedian $661 · 10th to 90th $380 to $871
$200$500$1K$2Kfacility $513professional $661

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
$512.86
Median
$512.86
Typical High
$630.96
Aetna
Setting
Professional
Modifier
Global
Typical Low
$380.19
Median
$512.86
Typical High
$2,818.38
BCBS
Setting
Professional
Modifier
Global
Typical Low
$588.84
Median
$776.25
Typical High
$851.14
Cigna
Setting
Facility
Modifier
Global
Typical Low
$398.11
Median
$398.11
Typical High
$398.11
Cigna
Setting
Professional
Modifier
Global
Typical Low
$398.11
Median
$870.96
Typical High
$1,096.48
Medica
Setting
Facility
Modifier
Global
Typical Low
$281.84
Median
$630.96
Typical High
$1,548.82
Medica
Setting
Professional
Modifier
Global
Typical Low
$281.84
Median
$354.81
Typical High
$707.95
United
Setting
Facility
Modifier
Global
Typical Low
$416.87
Median
$416.87
Typical High
$1,023.29
United
Setting
Professional
Modifier
Global
Typical Low
$263.03
Median
$478.63
Typical High
$891.25

Where North Dakota 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 Dakota· 6th of 51

$646

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.