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Iowa rates for HCPCS L5614

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,498.37 / $1,706.30 / $1,706.30
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$853.21 / $1,092.98 / $1,721.71
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,317.79 / $1,317.79 / $2,229.84
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,317.79 / $2,361.75 / $2,952.19
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,801.83 / $2,037.14 / $2,162.94
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,292.73 / $2,635.27 / $9,502.08
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$969.10 / $1,268.23 / $2,769.65
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,223.32 / $2,229.84 / $2,764.59
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,826.24 / $2,604.76 / $4,261.20
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$907.89 / $1,079.93 / $2,648.28
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,986.59 / $1,986.59 / $1,986.59
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,569.41 / $1,986.59 / $1,986.59