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Iowa rates for HCPCS L5160

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,740.49 / $4,752.33 / $4,752.33
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,909.75 / $2,770.40 / $4,080.53
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,670.30 / $3,670.30 / $5,751.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,670.30 / $6,577.50 / $8,221.87
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,822.70 / $5,673.77 / $6,244.35
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,334.09 / $6,796.63 / $24,492.50
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,499.41 / $3,194.91 / $7,143.22
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,734.18 / $5,751.00 / $6,964.46
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,710.10 / $6,717.95 / $10,990.03
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,585.02 / $2,608.28 / $6,720.59
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,123.62 / $5,123.62 / $5,123.62
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,047.66 / $5,123.62 / $5,123.62