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Iowa rates for HCPCS L5628

Addition to lower extremity, test socket, hemipelvectomy

Facilitymedian $646 · 10th–90th $417–$1,6600%20%10th90th$646Professionalmedian $389 · 10th–90th $257–$6920%20%10th90th$389$0.5$2.0$10.0$50.0$200.0$1.0K

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
$416.87 / $478.63 / $645.65
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$257.04 / $380.19 / $537.03
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$501.19 / $501.19 / $676.08
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$501.19 / $891.25 / $1,122.02
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$575.44 / $1,071.52 / $1,288.25
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$416.87 / $794.33 / $3,090.30
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$288.40 / $436.52 / $1,122.02
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$660.69 / $691.83 / $870.96
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$676.08 / $676.08 / $676.08
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$660.69 / $1,023.29 / $1,023.29
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$239.88 / $616.60 / $1,548.82
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$288.40 / $331.13 / $645.65
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$467.74 / $588.84 / $588.84