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

Wisconsin 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 $93 · 10th–90th $71$1700%20%40%10th90th$93Professionalmedian $87 · 10th–90th $46$1550%20%10th90th$87$0.1$0.5$2.0$10.0$50.0$200.0

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
$45.71
Median
$45.71
Typical High
$45.71
Aetna
Setting
Professional
Modifier
Global
Typical Low
$45.71
Median
$45.71
Typical High
$91.20
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$93.33
Median
$93.33
Typical High
$151.36
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$77.62
Median
$87.10
Typical High
$104.71
Cigna
Setting
Facility
Modifier
Global
Typical Low
$50.12
Median
$213.80
Typical High
$467.74
Cigna
Setting
Professional
Modifier
Global
Typical Low
$37.15
Median
$134.90
Typical High
$173.78
DeanCare
Setting
Facility
Modifier
Global
Typical Low
$45.71
Median
$74.13
Typical High
$114.82
DeanCare
Setting
Professional
Modifier
Global
Typical Low
$83.18
Median
$112.20
Typical High
$141.25
Medica
Setting
Facility
Modifier
Global
Typical Low
$45.71
Median
$91.20
Typical High
$426.58
Medica
Setting
Professional
Modifier
Global
Typical Low
$40.74
Median
$57.54
Typical High
$102.33
Molina
Setting
Professional
Modifier
Global
Typical Low
$48.98
Median
$58.88
Typical High
$85.11
Network Health
Setting
Professional
Modifier
Global
Typical Low
$66.07
Median
$104.71
Typical High
$181.97
Prevea360
Setting
Facility
Modifier
Global
Typical Low
$45.71
Median
$74.13
Typical High
$114.82
Prevea360
Setting
Professional
Modifier
Global
Typical Low
$52.48
Median
$89.13
Typical High
$91.20
Quartz
Setting
Professional
Modifier
Global
Typical Low
$93.33
Median
$138.04
Typical High
$245.47
Quartz
Setting
Facility
Modifier
Global
Typical Low
$50.12
Median
$186.21
Typical High
$436.52
Quartz
Setting
Professional
Modifier
Global
Typical Low
$37.15
Median
$138.04
Typical High
$467.74
Security Health
Setting
Professional
Modifier
Global
Typical Low
$72.44
Median
$83.18
Typical High
$85.11
United
Setting
Facility
Modifier
Global
Typical Low
$47.86
Median
$60.26
Typical High
$93.33
United
Setting
Professional
Modifier
Global
Typical Low
$33.88
Median
$47.86
Typical High
$83.18