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Iowa rates for HCPCS L5781

Addition to lower limb prosthesis, vacuum pump, residual limb volume management and moisture evacuation system

Facilitymedian $4,786 · 10th–90th $3,090–$13,1830%20%10th90th$4,786Professionalmedian $2,754 · 10th–90th $2,042–$4,7860%20%10th90th$2,754$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
$3,548.13 / $3,715.35 / $4,073.80
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,041.74 / $2,511.89 / $4,073.80
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,884.03 / $2,884.03 / $5,370.32
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,884.03 / $5,623.41 / $7,079.46
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,570.88 / $4,897.79 / $5,754.40
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,311.31 / $6,309.57 / $22,387.21
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,238.72 / $3,235.94 / $8,128.31
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5,248.07 / $5,495.41 / $6,606.93
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
$4,897.79 / $8,128.31 / $8,128.31
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,137.96 / $4,897.79 / $11,481.54
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,238.72 / $2,570.40 / $4,570.88
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,715.35 / $4,677.35 / $4,677.35