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Iowa rates for HCPCS A5114

Leg Strap; Foam Or Fabric Replacement Only Per Set (Special Coverage Instructions Apply. See Mcm: 2130)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.89 / $7.89 / $9.10
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.67 / $6.75 / $9.11
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.95 / $7.51 / $11.69
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.51 / $12.00 / $17.80
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.63 / $13.30 / $21.74
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.26 / $13.71 / $80.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.08 / $6.24 / $15.51
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11.69 / $13.66 / $16.48
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.77 / $13.96 / $22.54
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.08 / $5.48 / $9.43
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9.57 / $9.57 / $9.57
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.56 / $9.57 / $9.57