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Iowa rates for HCPCS L5685

Addition to lower extremity prosthesis, below knee, suspension/sealing sleeve, with or without valve, any material, each

Facilitymedian $155 · 10th–90th $100$4170%20%10th90th$155Professionalmedian $87 · 10th–90th $65$1700%20%10th90th$87$0.1$0.5$2.0$10.0$50.0$200.0

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
$112.20 / $120.23 / $128.82
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $79.43 / $128.82
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $173.78
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $177.83 / $223.87
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $169.82 / $223.87
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$104.71 / $199.53 / $724.44
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $104.71 / $257.04
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$169.82 / $177.83 / $208.93
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$173.78 / $173.78 / $173.78
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$158.49 / $257.04 / $257.04
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$67.61 / $158.49 / $363.08
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $81.28 / $154.88
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $151.36 / $151.36