go back

Below-Knee Prosthesis Protective Cover, Custom-Shaped

Rhode Island 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?

$398

Typical negotiated rate. In Rhode Island, July 2026.

Insurers have agreed to pay about $398 for this service. The price depends on where it is billed: about $398 from a physician practice, and about $1,175 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 4 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$398$309 to $427
FacilityA hospital or hospital-owned outpatient department$1,175$490 to $1,479

How much rates vary

Facilitymedian $1,175 · 10th to 90th $417 to $1,660Professionalmedian $398 · 10th to 90th $309 to $479
$500$1K$2Kfacility $1,175professional $398

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. Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$309.03
Median
$346.74
Typical High
$426.58
BCBS
Setting
Facility
Modifier
Global
Typical Low
$1,047.13
Median
$1,412.54
Typical High
$1,659.59
BCBS
Setting
Professional
Modifier
Global
Typical Low
$338.84
Median
$398.11
Typical High
$630.96
Cigna
Setting
Facility
Modifier
Global
Typical Low
$398.11
Median
$416.87
Typical High
$416.87
Cigna
Setting
Professional
Modifier
Global
Typical Low
$288.40
Median
$288.40
Typical High
$288.40
United
Setting
Facility
Modifier
Global
Typical Low
$416.87
Median
$489.78
Typical High
$851.14
United
Setting
Professional
Modifier
Global
Typical Low
$323.59
Median
$407.38
Typical High
$588.84

Where Rhode Island 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.

Rhode Island· 26th of 51

$398

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.