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Iowa rates for HCPCS L5656

Addition To Lower Extremity Socket Insert Knee Disarticulation (Kemblo Pelite Aliplast Plastazote Or Equal)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$334.27 / $434.84 / $434.84
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$188.51 / $267.41 / $396.24
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$335.84 / $335.84 / $554.94
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$485.53 / $601.88 / $752.34
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$452.52 / $519.16 / $617.71
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$321.73 / $655.84 / $2,344.02
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$241.18 / $310.29 / $689.29
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$553.33 / $554.94 / $676.37
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$454.51 / $648.26 / $1,060.50
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$222.12 / $260.08 / $661.18
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$494.40 / $494.40 / $494.40
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$390.58 / $494.40 / $494.40