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Below-Knee Prosthesis Protective Cover, Custom-Shaped

Wyoming 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?

$692

Typical negotiated rate. In Wyoming, October 2026.

Insurers have agreed to pay about $692 for this service. Most negotiated rates run $398 to $692.

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.

How much rates vary

Facilitymedian $398 · 10th to 90th $398 to $617Professionalmedian $692 · 10th to 90th $288 to $692
$200$500facility $398professional $692

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
$616.60
Median
$616.60
Typical High
$616.60
Aetna
Setting
Professional
Modifier
None
Typical Low
$363.08
Median
$616.60
Typical High
$616.60
BCBS Wyoming
Setting
Professional
Modifier
None
Typical Low
$691.83
Median
$691.83
Typical High
$691.83
BCBS Wyoming
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$489.78
Median
$489.78
Typical High
$489.78
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
United
Setting
Professional
Modifier
None
Typical Low
$281.84
Median
$316.23
Typical High
$478.63

Where Wyoming 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.

Wyoming· 8th of 51

$692

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.