go back

Iowa rates for HCPCS L5629

Addition to lower extremity, below knee, acrylic socket

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$277.52 / $319.48 / $319.48
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$158.90 / $229.09 / $320.63
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$248.05 / $248.05 / $419.57
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$248.05 / $442.13 / $552.66
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$369.94 / $414.82 / $549.86
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$243.24 / $503.11 / $2,003.74
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$188.60 / $253.73 / $521.16
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$418.35 / $419.57 / $579.45
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$343.63 / $490.12 / $801.81
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$188.60 / $222.67 / $448.84
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$373.80 / $373.80 / $373.80
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$295.30 / $373.80 / $373.80