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Iowa rates for HCPCS L5642

Addition to lower extremity, above knee (AK), leather socket

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$686.76 / $686.76 / $721.37
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$309.77 / $446.62 / $651.15
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$530.41 / $530.41 / $838.20
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$766.80 / $950.63 / $1,188.28
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$739.02 / $835.88 / $1,024.24
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$485.94 / $990.60 / $3,873.08
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$370.99 / $494.65 / $1,041.09
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$835.74 / $838.20 / $1,129.69
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$744.00 / $979.13 / $1,601.76
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$370.99 / $380.15 / $681.75
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$746.76 / $746.76 / $746.76
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$589.94 / $746.76 / $746.76