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Iowa rates for HCPCS L8415

Prosthetic sheath, upper limb, each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19.95 / $21.88 / $21.88
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.00 / $14.13 / $21.88
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.22 / $16.22 / $33.11
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.22 / $30.20 / $37.15
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.12 / $33.88 / $39.81
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19.95 / $36.31 / $134.90
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.80 / $19.50 / $48.98
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $38.90
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$33.11 / $33.11 / $33.11
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.51 / $48.98 / $48.98
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11.22 / $19.95 / $41.69
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.18 / $14.79 / $25.70
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.39 / $28.84 / $28.84