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Iowa rates for HCPCS L5701

Replacement, socket, above knee (AK)/knee disarticulation, including attachment plate, molded to patient model

Facilitymedian $4,571 · 10th–90th $2,818–$12,3030%20%10th90th$4,571Professionalmedian $2,455 · 10th–90th $1,778–$4,7860%10%20%10th90th$2,455$5.0$20.0$100.0$500.0$2.0K$10.0K

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
$3,311.31 / $3,715.35 / $3,890.45
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,778.28 / $2,290.87 / $3,715.35
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,570.40 / $2,570.40 / $5,370.32
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,570.40 / $5,370.32 / $6,606.93
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,073.80 / $4,786.30 / $5,370.32
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,235.94 / $6,165.95 / $21,379.62
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,238.72 / $3,090.30 / $7,943.28
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5,248.07 / $5,495.41 / $6,165.95
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,370.32 / $5,370.32 / $5,370.32
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,677.35 / $7,943.28 / $7,943.28
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,995.26 / $4,897.79 / $10,715.19
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,187.76 / $2,511.89 / $4,570.88
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,715.35 / $4,677.35 / $4,677.35