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Iowa rates for HCPCS L5692

Addition to lower extremity, above knee (AK), pelvic control belt, light

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$120.23 / $147.91 / $147.91
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.61 / $89.13 / $144.54
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $213.80
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$100.00 / $186.21 / $229.09
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$158.49 / $199.53 / $239.88
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$131.83 / $229.09 / $831.76
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$89.13 / $123.03 / $323.59
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$208.93 / $218.78 / $251.19
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$213.80 / $213.80 / $213.80
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$181.97 / $323.59 / $323.59
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$79.43 / $123.03 / $263.03
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.43 / $95.50 / $165.96
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$147.91 / $186.21 / $186.21