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Iowa rates for HCPCS L5703

Ankle, Symes, molded to patient model, socket without solid ankle cushion heel (SACH) foot, replacement only

Facilitymedian $2,692 · 10th–90th $1,738–$7,5860%20%10th90th$2,692Professionalmedian $1,622 · 10th–90th $1,122–$2,8840%20%10th90th$1,622$2.0$10.0$50.0$200.0$1.0K$5.0K

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
$1,949.84 / $1,949.84 / $2,570.40
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,122.02 / $1,548.82 / $2,344.23
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,137.96 / $2,137.96 / $2,818.38
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,137.96 / $3,548.13 / $4,365.16
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,454.71 / $3,019.95 / $3,548.13
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,737.80 / $3,311.31 / $13,182.57
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,202.26 / $1,862.09 / $4,466.84
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,754.23 / $2,884.03 / $3,801.89
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,818.38 / $2,818.38 / $2,818.38
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,884.03 / $4,265.80 / $4,265.80
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,230.27 / $2,570.40 / $6,606.93
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,258.93 / $1,412.54 / $3,019.95
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,949.84 / $2,454.71 / $2,454.71