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Iowa rates for HCPCS L5988

Addition to lower limb prosthesis, vertical shock reducing pylon feature

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,773.78 / $2,019.99 / $2,019.99
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,010.07 / $1,293.94 / $2,038.23
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,346.19 / $1,346.19 / $2,639.78
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,346.19 / $2,796.00 / $3,495.00
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,291.06 / $2,424.69 / $2,942.92
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,530.39 / $3,119.74 / $11,271.87
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,147.25 / $1,501.40 / $3,278.81
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,632.06 / $2,639.78 / $3,272.85
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,161.98 / $3,083.62 / $5,044.55
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,143.85 / $1,278.47 / $3,135.13
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,351.80 / $2,351.80 / $2,351.80
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,857.92 / $2,351.80 / $2,351.80