go back

Iowa rates for HCPCS L5649

Addition to lower extremity, ischial containment/narrow M-L socket

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,851.24 / $2,478.41 / $2,478.41
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,071.32 / $1,457.30 / $2,478.41
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,800.00 / $1,800.00 / $2,513.71
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,800.00 / $3,430.50 / $4,288.13
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,216.33 / $2,940.96 / $3,115.20
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,457.30 / $3,012.70 / $11,959.60
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,129.88 / $1,520.07 / $3,122.23
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,506.35 / $2,513.71 / $3,471.55
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,168.98 / $2,970.75 / $4,803.62
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,129.88 / $1,178.06 / $2,994.92
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,239.48 / $2,239.48 / $2,239.48
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,769.20 / $2,239.48 / $2,239.48