go back

Below-Knee Prosthesis Protective Cover, Custom-Shaped

West Virginia 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?

$355

Typical negotiated rate. In West Virginia, October 2026.

Insurers have agreed to pay about $355 for this service. The price depends on where it is billed: about $355 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 5 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$355$347 to $479
FacilityA hospital or hospital-owned outpatient department$398$398 to $417

How much rates vary

Facilitymedian $398 · 10th to 90th $398 to $724Professionalmedian $355 · 10th to 90th $288 to $794
$500$1K$2Kfacility $398professional $355

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
Professional
Modifier
None
Typical Low
$346.74
Median
$346.74
Typical High
$346.74
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$173.78
Median
$173.78
Typical High
$173.78
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$69.18
Median
$69.18
Typical High
$69.18
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$51.29
Median
$51.29
Typical High
$51.29
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$34.67
Median
$34.67
Typical High
$34.67
CareSource
Setting
Facility
Modifier
None
Typical Low
$416.87
Median
$416.87
Typical High
$416.87
CareSource
Setting
Professional
Modifier
None
Typical Low
$446.68
Median
$446.68
Typical High
$776.25
Cigna
Setting
Facility
Modifier
None
Typical Low
$398.11
Median
$398.11
Typical High
$977.24
Cigna
Setting
Professional
Modifier
None
Typical Low
$288.40
Median
$288.40
Typical High
$3,467.37
Highmark BCBS
Setting
Professional
Modifier
None
Typical Low
$489.78
Median
$489.78
Typical High
$489.78
United
Setting
Facility
Modifier
None
Typical Low
$363.08
Median
$363.08
Typical High
$724.44
United
Setting
Professional
Modifier
None
Typical Low
$346.74
Median
$436.52
Typical High
$794.33

Where West Virginia 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.

West Virginia· 47th of 51

$355

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.