go back

Below-Knee Prosthesis Protective Cover, Custom-Shaped

Tennessee 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?

$309

Typical negotiated rate. In Tennessee, July 2026.

Insurers have agreed to pay about $309 for this service. The price depends on where it is billed: about $309 from a physician practice, and about $490 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 6 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$309$282 to $427
FacilityA hospital or hospital-owned outpatient department$490$417 to $3,548

How much rates vary

Facilitymedian $490 · 10th to 90th $275 to $3,548Professionalmedian $309 · 10th to 90th $275 to $537
$200$500$1K$2K$5Kfacility $490professional $309

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
$275.42
Median
$275.42
Typical High
$489.78
Aetna
Setting
Professional
Modifier
Global
Typical Low
$275.42
Median
$309.03
Typical High
$537.03
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$489.78
Median
$562.34
Typical High
$588.84
BCBS
Setting
Professional
Modifier
Global
Typical Low
$489.78
Median
$489.78
Typical High
$524.81
Cigna
Setting
Facility
Modifier
Global
Typical Low
$398.11
Median
$398.11
Typical High
$457.09
Cigna
Setting
Professional
Modifier
Global
Typical Low
$288.40
Median
$288.40
Typical High
$398.11
Lucent Health
Setting
Facility
Modifier
Global
Typical Low
$3,548.13
Median
$3,548.13
Typical High
$3,548.13
Lucent Health
Setting
Professional
Modifier
Global
Typical Low
$3,715.35
Median
$5,128.61
Typical High
$5,128.61
United
Setting
Facility
Modifier
Global
Typical Low
$281.84
Median
$478.63
Typical High
$660.69
United
Setting
Professional
Modifier
Global
Typical Low
$213.80
Median
$316.23
Typical High
$478.63

Where Tennessee 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.

Tennessee· 50th of 51

$309

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.