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Iowa rates for HCPCS L5697

Addition to lower extremity, above knee (AK) or knee disarticulation, pelvic band

Facilitymedian $98 · 10th–90th $66$2750%20%10th90th$98Professionalmedian $60 · 10th–90th $41$1070%20%10th90th$60$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
$75.86 / $75.86 / $93.33
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$40.74 / $56.23 / $83.18
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$60.26 / $60.26 / $107.15
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $128.82 / $162.18
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $112.20 / $125.89
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$66.07 / $125.89 / $512.86
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$47.86 / $69.18 / $162.18
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $109.65 / $147.91
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$107.15 / $107.15 / $107.15
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $162.18 / $162.18
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$47.86 / $97.72 / $257.04
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$47.86 / $53.70 / $93.33
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $95.50 / $95.50