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Iowa rates for HCPCS L5795

Addition, exoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$937.58 / $1,079.40 / $1,079.40
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$575.49 / $773.99 / $1,444.38
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$908.11 / $908.11 / $1,417.56
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,205.18 / $1,494.00 / $1,867.50
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,249.85 / $1,586.04 / $1,903.89
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$821.82 / $1,675.30 / $6,807.72
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$637.17 / $857.22 / $1,760.72
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,413.40 / $1,417.56 / $1,957.71
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,160.99 / $1,655.90 / $2,708.92
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,061.90 / $2,061.90 / $3,350.59
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$637.17 / $764.74 / $1,516.33
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,262.92 / $1,262.92 / $1,262.92
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$997.71 / $1,262.92 / $1,262.92