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Below-Knee Prosthesis Protective Cover, Custom-Shaped

New Mexico rates for HCPCS L5704

Custom shaped protective cover, below knee (BK)

Rates data updated October 2026.

How much does Below-Knee Prosthesis Protective Cover, Custom-Shaped cost?

$479

Typical negotiated rate. In New Mexico, October 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 $398 from a hospital or other facility.

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.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$479$324 to $617
FacilityA hospital or hospital-owned outpatient department$398$204 to $457

How much rates vary

Facilitymedian $398 · 10th to 90th $204 to $490Professionalmedian $479 · 10th to 90th $288 to $933
$200$500$1Kfacility $398professional $479

Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$354.81
Median
$354.81
Typical High
$354.81
Aetna
Setting
Professional
Modifier
None
Typical Low
$331.13
Median
$489.78
Typical High
$489.78
BCBS New Mexico
Setting
Professional
Modifier
None
Typical Low
$389.05
Median
$512.86
Typical High
$616.60
Cigna
Setting
Facility
Modifier
None
Typical Low
$398.11
Median
$398.11
Typical High
$398.11
Cigna
Setting
Professional
Modifier
None
Typical Low
$288.40
Median
$288.40
Typical High
$398.11
Molina
Setting
Professional
Modifier
None
Typical Low
$758.58
Median
$933.25
Typical High
$1,412.54
Providence
Setting
Facility
Modifier
None
Typical Low
$204.17
Median
$398.11
Typical High
$489.78
Providence
Setting
Professional
Modifier
None
Typical Low
$288.40
Median
$288.40
Typical High
$870.96
United
Setting
Facility
Modifier
None
Typical Low
$724.44
Median
$724.44
Typical High
$851.14
United
Setting
Professional
Modifier
None
Typical Low
$288.40
Median
$316.23
Typical High
$489.78

Where New Mexico sits

The same service costs 2.8 times more in Hawaii than in Delaware. 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 Mexico· 21st of 51

$479

HI $794DE $288

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.