go back

Below-Knee Prosthesis Protective Cover, Custom-Shaped

New Jersey 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?

$339

Typical negotiated rate. In New Jersey, July 2026.

Insurers have agreed to pay about $339 for this service. The price depends on where it is billed: about $339 from a physician practice, and about $251 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$339$295 to $589
FacilityA hospital or hospital-owned outpatient department$251$251 to $479

How much rates vary

Facilitymedian $251 · 10th to 90th $251 to $692Professionalmedian $339 · 10th to 90th $257 to $676
$200$500$1K$2Kfacility $251professional $339

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
$251.19
Median
$251.19
Typical High
$251.19
Aetna
Setting
Professional
Modifier
Global
Typical Low
$251.19
Median
$331.13
Typical High
$588.84
Cigna
Setting
Facility
Modifier
Global
Typical Low
$363.08
Median
$398.11
Typical High
$691.83
Cigna
Setting
Professional
Modifier
Global
Typical Low
$288.40
Median
$288.40
Typical High
$398.11
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$457.09
Median
$660.69
Typical High
$912.01
Horizon BCBS
Setting
Professional
Modifier
Global
Typical Low
$676.08
Median
$676.08
Typical High
$676.08
United
Setting
Facility
Modifier
Global
Typical Low
$416.87
Median
$691.83
Typical High
$691.83
United
Setting
Professional
Modifier
Global
Typical Low
$309.03
Median
$416.87
Typical High
$676.08

Where New Jersey 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.

New Jersey· 47th of 51

$339

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.