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Below-Knee Suspension/Sealing Sleeve

Iowa rates for HCPCS L5685

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

Rates data updated July 2026.

Facilitymedian $129 · 10th–90th $95$3890%20%10th90th$129Professionalmedian $115 · 10th–90th $68$2000%20%10th90th$115$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
Setting
Facility
Modifier
Global
Typical Low
$75.86
Median
$120.23
Typical High
$128.82
Aetna
Setting
Professional
Modifier
Global
Typical Low
$64.57
Median
$97.72
Typical High
$151.36
Cigna
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$173.78
Cigna
Setting
Professional
Modifier
Global
Typical Low
$100.00
Median
$177.83
Typical High
$223.87
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$147.91
Median
$169.82
Typical High
$223.87
Medica
Setting
Facility
Modifier
Global
Typical Low
$104.71
Median
$199.53
Typical High
$724.44
Medica
Setting
Professional
Modifier
Global
Typical Low
$74.13
Median
$104.71
Typical High
$257.04
Midlands
Setting
Professional
Modifier
Global
Typical Low
$169.82
Median
$181.97
Typical High
$213.80
Midlands
Setting
Facility
Modifier
Global
Typical Low
$173.78
Median
$173.78
Typical High
$173.78
Midlands
Setting
Professional
Modifier
Global
Typical Low
$158.49
Median
$257.04
Typical High
$257.04
United
Setting
Facility
Modifier
Global
Typical Low
$91.20
Median
$158.49
Typical High
$302.00
United
Setting
Professional
Modifier
Global
Typical Low
$72.44
Median
$87.10
Typical High
$158.49
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$120.23
Median
$154.88
Typical High
$154.88