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Iowa rates for HCPCS L5677

Additions To Lower Extremity Below Knee Knee Joints Polycentric Pair

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$430.55 / $557.92 / $557.92
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$246.52 / $355.43 / $518.19
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$400.78 / $400.78 / $700.25
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$400.78 / $772.13 / $965.16
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$591.78 / $666.10 / $774.08
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$405.97 / $827.57 / $3,128.35
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$304.33 / $406.64 / $869.76
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$698.20 / $700.25 / $899.01
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$573.50 / $817.99 / $1,338.15
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$304.33 / $317.58 / $748.98
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$623.86 / $623.86 / $623.86
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$492.85 / $623.86 / $623.86