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Iowa rates for HCPCS L5648

Addition To Lower Extremity Above Knee Air Fluid Gel Or Equal Cushion Socket. (Rvsdf 1/1/04)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$737.61 / $737.61 / $766.55
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$329.18 / $474.60 / $691.93
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$589.44 / $589.44 / $951.16
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$589.44 / $1,020.75 / $1,275.94
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$790.21 / $880.62 / $1,007.84
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$551.41 / $1,124.09 / $4,115.68
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$413.38 / $550.70 / $1,181.41
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$948.37 / $951.16 / $1,200.44
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$779.00 / $1,111.08 / $1,817.64
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$398.85 / $468.93 / $1,133.24
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$847.40 / $847.40 / $847.40
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$669.45 / $847.40 / $847.40