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Iowa rates for HCPCS L5964

Addition, endoskeletal system, above knee (AK), flexible protective outer surface covering system

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$933.25 / $1,071.52 / $1,122.02
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$478.63 / $676.08 / $1,071.52
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$707.95 / $707.95 / $1,548.82
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$707.95 / $1,584.89 / $1,949.84
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,148.15 / $1,380.38 / $1,479.11
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$933.25 / $1,698.24 / $5,888.44
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$645.65 / $870.96 / $2,290.87
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,513.56 / $1,584.89 / $1,778.28
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,548.82 / $1,548.82 / $1,548.82
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,288.25 / $2,290.87 / $2,290.87
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$549.54 / $870.96 / $1,819.70
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$630.96 / $691.83 / $1,258.93
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,071.52 / $1,348.96 / $1,348.96