go back

Iowa rates for HCPCS L5668

Addition to lower extremity, below knee (BK), molded distal cushion

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$87.10 / $95.50 / $114.82
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$56.23 / $72.44 / $114.82
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$89.13 / $89.13 / $138.04
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$89.13 / $158.49 / $199.53
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$117.49 / $138.04 / $165.96
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$83.18 / $158.49 / $645.65
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.26 / $89.13 / $204.17
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$134.90 / $141.25 / $186.21
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$138.04 / $138.04 / $138.04
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$138.04 / $204.17 / $204.17
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$60.26 / $93.33 / $199.53
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.26 / $66.07 / $114.82
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$95.50 / $120.23 / $120.23