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Iowa rates for HCPCS L5665

Addition to lower extremity, socket insert, multidurometer, below knee (BK)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$447.12 / $585.47 / $585.47
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$256.01 / $369.10 / $585.47
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$452.18 / $452.18 / $890.80
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$452.18 / $810.38 / $1,012.97
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$664.04 / $780.02 / $866.69
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$516.44 / $983.28 / $3,241.88
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$364.69 / $459.89 / $1,061.33
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$888.19 / $890.80 / $1,067.63
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$705.45 / $959.32 / $1,702.29
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$983.28 / $983.28 / $1,597.83
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$348.72 / $408.14 / $952.89
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$793.62 / $793.62 / $793.62
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$626.96 / $793.62 / $793.62