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Prosthetic Sheath/Sock with Gel Cushion, Below or Above Knee

Pennsylvania rates for HCPCS L8417

Prosthetic sheath/sock, including a gel cushion layer, below knee (BK) or above knee (AK), each

Rates data updated July 2026.

Facilitymedian $138 · 10th–90th $40$4680%20%10th90th$138Professionalmedian $44 · 10th–90th $36$890%20%40%10th90th$44$0.1$1.0$10.0$100.0$1.0K$10.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$39.81
Median
$39.81
Typical High
$151.36
Aetna
Setting
Professional
Modifier
Global
Typical Low
$34.67
Median
$43.65
Typical High
$67.61
Capital Blue Cross
Setting
Facility
Modifier
Global
Typical Low
$5,011.87
Median
$8,511.38
Typical High
$77,624.71
Capital Blue Cross
Setting
Professional
Modifier
Global
Typical Low
$89.13
Median
$89.13
Typical High
$89.13
Cigna
Setting
Facility
Modifier
Global
Typical Low
$50.12
Median
$50.12
Typical High
$125.89
Cigna
Setting
Professional
Modifier
Global
Typical Low
$37.15
Median
$37.15
Typical High
$50.12
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$83.18
Median
$117.49
Typical High
$169.82
Geisinger
Setting
Facility
Modifier
Global
Typical Low
$91.20
Median
$91.20
Typical High
$91.20
Geisinger
Setting
Professional
Modifier
Global
Typical Low
$53.70
Median
$63.10
Typical High
$91.20
Highmark BCBS
Setting
Professional
Modifier
Global
Typical Low
$61.66
Median
$61.66
Typical High
$61.66
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$39.81
Median
$39.81
Typical High
$151.36
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$36.31
Median
$43.65
Typical High
$67.61
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$81.28
Median
$81.28
Typical High
$81.28
UPMC Health Plan
Setting
Facility
Modifier
Global
Typical Low
$104.71
Median
$316.23
Typical High
$512.86
UPMC Health Plan
Setting
Professional
Modifier
Global
Typical Low
$63.10
Median
$85.11
Typical High
$87.10
United
Setting
Facility
Modifier
Global
Typical Low
$36.31
Median
$109.65
Typical High
$109.65
United
Setting
Professional
Modifier
Global
Typical Low
$36.31
Median
$50.12
Typical High
$91.20