Custom below-knee protective cover

Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.

Model: claude-haiku-5-5
Provider: anthropic
API: message_batches
Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

Custom shape cover bk

Payers reporting HCPCS L5704

Payer pricing summary

Low

$194

Average

$851

Median

$777

High

$1.5k

Payer rate distribution

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Filter by billing class

#
1	UnitedHealthcare fee schedule · outpatient · +17 other terms	362	$669	$712	$191	27%	—	$315 – $2.5k
2	Aetna fee schedule · outpatient · +16 other terms	361	$689	$821	$426	52%	—	$314 – $5.0k
3	Humana fee schedule · outpatient · +13 other terms	321	$683	$1.0k	$1.0k	104%	—	$402 – $5.0k
4	Blue Cross Blue Shield fee schedule · outpatient · +13 other terms	223	$669	$940	$540	58%	—	$0 – $3.4k
5	WellCare fee schedule · outpatient · +5 other terms	208	$689	$711	$124	17%	—	$643 – $1.4k
6	Devoted fee schedule · outpatient · +4 other terms	165	$656	$670	$29	4%	—	$656 – $876
7	Molina fee schedule · outpatient · +8 other terms	144	$966	$928	$350	38%	—	$443 – $1.7k
8	Cigna Healthspring fee schedule · outpatient · +2 other terms	116	$702	$679	$37	6%	—	$656 – $885
9	Cigna fee schedule · outpatient · +14 other terms	108	$710	$832	$278	33%	—	$448 – $2.3k
10	Anthem fee schedule · outpatient · +12 other terms	84	$725	$980	$974	99%	—	$389 – $5.8k
11	Kaiser fee schedule · outpatient · +8 other terms	68	$739	$1.2k	$846	73%	—	$389 – $5.5k
12	Ambetter facility · fee schedule · outpatient · +6 other terms	42	$1.1k	$1.3k	$270	21%	—	$559 – $1.6k
13	Superior Healthplan fee schedule · outpatient	40	$689	$689	$3	0%	—	$643 – $689
14	Clover fee schedule · outpatient · +3 other terms	37	$683	$688	$28	4%	—	$656 – $860
15	Oscar fee schedule · outpatient · +6 other terms	36	$689	$794	$218	27%	—	$643 – $1.3k
16	Optum fee schedule · outpatient · +4 other terms	33	$710	$895	$325	36%	—	$656 – $1.6k
17	Caresource fee schedule · outpatient · +5 other terms	29	$656	$729	$257	35%	—	$359 – $1.2k
18	Medica facility · fee schedule · outpatient · +5 other terms	22	$788	$719	$187	26%	—	$257 – $1.3k
19	Regence facility · fee schedule · outpatient · +4 other terms	19	$754	$735	$40	5%	—	$622 – $768
20	Amerihealth Caritas fee schedule · outpatient · +1 other terms	18	$787	$775	$21	3%	—	$734 – $787
21	Bcbs Tx fee schedule · outpatient	18	$643	$643	—	—	—	$643 – $643
22	Medicare fee schedule · outpatient · +3 other terms	18	$697	$699	$5	1%	—	$697 – $711
23	Medical Mutual facility · fee schedule · outpatient · +2 other terms	15	$770	$885	$219	25%	—	$419 – $1.2k
24	Bcbs Mn fee schedule · outpatient · +6 other terms	13	$700	$700	$163	23%	—	$341 – $820
25	Tricare facility · fee schedule · outpatient · +2 other terms	13	$711	$699	$29	4%	—	$627 – $719

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