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Unclassified Wheelchair Seat or Back Cushion

South Dakota rates for HCPCS K0669

Wheelchair accessory, wheelchair seat or back cushion, does not meet specific code criteria or no written coding verification from DME PDAC

Rates data updated October 2026.

How much does Unclassified Wheelchair Seat or Back Cushion cost?

$100

Typical negotiated rate. In South Dakota, October 2026.

Insurers have agreed to pay about $100 for this service. The price depends on where it is billed: about $871 from a physician practice, and about $100 from a hospital or other facility.

Few insurers publish rates for this combination, so treat this figure as a rough guide.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 4 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$871$58.88 to $1,096
FacilityA hospital or hospital-owned outpatient department$100$100 to $100

How much rates vary

Facilitymedian $100 · 10th to 90th $68 to $162Professionalmedian $871 · 10th to 90th $59 to $1,096
$50$100$200$500$1Kfacility $100professional $871

Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$67.61
Median
$67.61
Typical High
$67.61
Aetna
Setting
Professional
Modifier
None
Typical Low
$58.88
Median
$58.88
Typical High
$58.88
Cigna
Setting
Facility
Modifier
None
Typical Low
$30.90
Median
$30.90
Typical High
$30.90
Cigna
Setting
Professional
Modifier
None
Typical Low
$870.96
Median
$870.96
Typical High
$1,096.48
Medica
Setting
Facility
Modifier
None
Typical Low
$95.50
Median
$100.00
Typical High
$162.18
Midlands
Setting
Professional
Modifier
None
Typical Low
$47.86
Median
$47.86
Typical High
$47.86

Where South Dakota sits

The same service costs 51.3 times more in Arkansas than in Connecticut. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

South Dakota· 2nd of 51

$100

AR $275CT $5.37

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.