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Iowa rates for HCPCS L5855

Addition Endoskeletal System Hip Disarticulation Mechanical Hip Extension Assist

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$310.47 / $310.47 / $357.52
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$165.53 / $222.62 / $361.27
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$239.78 / $239.78 / $543.65
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$239.78 / $429.75 / $543.65
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$370.68 / $456.74 / $494.23
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$315.18 / $593.08 / $1,982.96
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$219.97 / $277.39 / $647.72
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$542.05 / $543.65 / $651.58
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$425.50 / $585.46 / $1,038.92
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$247.02 / $247.02 / $247.02
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$213.72 / $246.57 / $647.72
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$484.35 / $484.35 / $484.35
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$382.64 / $484.35 / $484.35