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Iowa rates for HCPCS L5613

Addition to lower extremity, endoskeletal system, above knee (AK), knee disarticulation, four-bar linkage, with hydraulic swing phase control

Facilitymedian $3,467 · 10th–90th $2,042–$8,9130%20%10th90th$3,467Professionalmedian $1,778 · 10th–90th $1,288–$3,5480%20%10th90th$1,778$2.0$10.0$50.0$200.0$1.0K$5.0K

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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,454.71 / $2,818.38 / $2,818.38
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,288.25 / $1,698.24 / $2,691.53
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,905.46 / $1,905.46 / $3,981.07
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,905.46 / $3,388.44 / $4,265.80
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,951.21 / $3,548.13 / $4,168.69
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,454.71 / $4,466.84 / $15,488.17
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,659.59 / $2,238.72 / $6,025.60
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,890.45 / $4,073.80 / $4,677.35
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,981.07 / $3,981.07 / $3,981.07
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,388.44 / $6,025.60 / $6,025.60
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,445.44 / $3,630.78 / $7,762.47
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,479.11 / $1,819.70 / $3,162.28
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,754.23 / $3,548.13 / $3,548.13