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Iowa rates for HCPCS L5617

Addition to lower extremity, quick change self-aligning unit, above knee (AK) or below knee (BK), each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$495.28 / $565.75 / $565.75
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$282.89 / $364.72 / $570.86
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$436.96 / $436.96 / $738.58
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$436.96 / $783.00 / $978.75
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$636.49 / $675.45 / $764.05
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$428.18 / $872.87 / $3,169.20
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$320.99 / $423.20 / $917.37
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$736.42 / $738.58 / $922.53
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$604.90 / $862.76 / $1,411.39
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$309.70 / $360.37 / $878.09
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$658.01 / $658.01 / $658.01
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$519.83 / $658.01 / $658.01