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Iowa rates for HCPCS L5790

Addition, exoskeletal system, above knee (AK), ultra-light material (titanium, carbon fiber or equal)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$627.87 / $753.83 / $753.83
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$359.50 / $518.32 / $753.83
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$582.20 / $582.20 / $975.39
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$582.20 / $1,043.25 / $1,304.06
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$854.99 / $1,036.85 / $1,308.15
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$565.48 / $1,152.74 / $4,473.42
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$430.54 / $574.05 / $1,211.53
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$972.54 / $975.39 / $1,311.03
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$798.86 / $1,139.40 / $1,863.98
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$500.36 / $500.36 / $500.36
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$430.54 / $503.62 / $1,162.13
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$868.99 / $868.99 / $868.99
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$686.50 / $868.99 / $868.99