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Iowa rates for HCPCS L5699

All lower extremity prostheses, shoulder harness

Facilitymedian $229 · 10th–90th $155–$6460%20%10th90th$229Professionalmedian $141 · 10th–90th $100–$2450%20%10th90th$141$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
$162.18 / $173.78 / $204.17
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $125.89 / $239.88
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$169.82 / $169.82 / $251.19
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$169.82 / $288.40 / $354.81
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $288.40 / $346.74
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$151.36 / $295.12 / $1,202.26
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $158.49 / $371.54
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$245.47 / $257.04 / $338.84
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$251.19 / $251.19 / $251.19
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$257.04 / $371.54 / $371.54
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$109.65 / $229.09 / $588.84
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $123.03 / $213.80
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$173.78 / $218.78 / $218.78