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Iowa rates for HCPCS L5658

Addition to lower extremity, socket insert, above knee (AK) (Kemblo, Pelite, Aliplast, Plastazote or equal)

Facilitymedian $513 · 10th–90th $339–$1,3180%20%10th90th$513Professionalmedian $288 · 10th–90th $186–$5250%10%20%10th90th$288$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
$363.08 / $407.38 / $457.09
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $269.15 / $407.38
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$363.08 / $363.08 / $588.84
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$363.08 / $630.96 / $794.33
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$446.68 / $524.81 / $549.54
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$363.08 / $676.08 / $2,344.23
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$245.47 / $331.13 / $870.96
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$575.44 / $602.56 / $676.08
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$588.84 / $588.84 / $588.84
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$501.19 / $870.96 / $870.96
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$181.97 / $537.03 / $1,148.15
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$239.88 / $281.84 / $501.19
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$407.38 / $512.86 / $512.86