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Iowa rates for HCPCS L5694

Addition to lower extremity, above knee (AK), pelvic control belt, padded and lined

Facilitymedian $219 · 10th–90th $148–$6170%20%10th90th$219Professionalmedian $138 · 10th–90th $91–$2450%20%10th90th$138$0.2$1.0$5.0$20.0$100.0$500.0

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
$169.82 / $169.82 / $181.97
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$91.20 / $123.03 / $181.97
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$141.25 / $141.25 / $245.47
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$141.25 / $251.19 / $316.23
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$208.93 / $257.04 / $281.84
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$147.91 / $288.40 / $1,174.90
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $158.49 / $363.08
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$239.88 / $251.19 / $331.13
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$245.47 / $245.47 / $245.47
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$251.19 / $363.08 / $363.08
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$107.15 / $223.87 / $575.44
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $117.49 / $218.78
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$169.82 / $213.80 / $213.80