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Iowa rates for HCPCS L5654

Addition to lower extremity, socket insert, Symes, (Kemblo, Pelite, Aliplast, Plastazote or equal)

Facilitymedian $427 · 10th–90th $288–$1,1480%10%20%10th90th$427Professionalmedian $257 · 10th–90th $170–$4570%10%20%10th90th$257$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
$288.40 / $331.13 / $398.11
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$169.82 / $239.88 / $346.74
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$309.03 / $309.03 / $478.63
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$309.03 / $549.54 / $691.83
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$398.11 / $478.63 / $512.86
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$288.40 / $549.54 / $2,089.30
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$204.17 / $302.00 / $707.95
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$467.74 / $489.78 / $602.56
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$478.63 / $478.63 / $478.63
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$457.09 / $707.95 / $707.95
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$194.98 / $436.52 / $1,047.13
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$199.53 / $229.09 / $407.38
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$331.13 / $416.87 / $416.87