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Iowa rates for HCPCS L5150

Knee disarticulation (or through knee), molded socket, external knee joints, shin, SACH foot

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,388.44 / $3,801.89 / $4,365.16
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,819.70 / $2,511.89 / $3,801.89
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,235.94 / $3,235.94 / $5,495.41
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,235.94 / $6,025.60 / $7,413.10
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,168.69 / $5,128.61 / $5,754.40
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,388.44 / $6,309.57 / $22,387.21
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,344.23 / $3,162.28 / $8,317.64
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,370.32 / $5,623.41 / $6,456.54
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,495.41 / $5,495.41 / $5,495.41
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,786.30 / $8,317.64 / $8,317.64
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,995.26 / $3,235.94 / $6,918.31
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,290.87 / $2,511.89 / $4,466.84
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,801.89 / $4,786.30 / $4,786.30